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[Hemoglobin: simply a laboratory value or a powerful predictor of risk in patients with acute coronary syndrome?].
Rev Port Cardiol 2012; 31(2):121-31RP

Abstract

INTRODUCTION

Anemia has been shown to be associated with a worse prognosis, especially higher mortality in various pathological conditions. However, few studies have specifically examined its impact in acute coronary syndrome (ACS) patients. The purpose of our study was to assess the association between different quartiles of hemoglobin on admission and short- and long-term prognosis in patients with ACS.

METHODS

We performed a retrospective analysis of 1303 consecutive ACS patients admitted to a coronary care unit and analyzed the association between baseline hemoglobin and morbidity and mortality, in-hospital and at 12-month follow-up. The population was divided into groups according to quartiles of hemoglobin concentration (Hb): Q1: <10.8g/dl; Q2: 10.8-12.2g/dl; Q3: 12.3-13.2g/dl; Q4: ≥13.3g/dl. Logistic regression analysis was used to identify independent predictors of short- and long-term mortality.

RESULTS

Hypertension and diabetes mellitus were more common in the lower Hb quartiles, while the prevalence of smoking and physical inactivity increased with higher Hb. A higher proportion of patients in the lower quartiles had congestive heart failure, peripheral artery disease and previous stroke or transient ischemic attack. Anemic patients tended to be older, with worse renal function and left ventricular systolic function. Patients in Q1 had significantly higher levels of troponin I and blood glucose on admission. Anemic patients showed significantly higher in-hospital mortality (Q1: 9.8%; Q2: 6.3%; Q3: 4.1%; Q4: 3.6%, p<0.001), longer hospital stay (Q1: 6.1±4.4; Q2: 5.2±3.0; Q3: 4.9±2.7; Q4 4.3±2.1 days, p<0.001) and higher 1-year mortality (Q1: 23.6%; Q2: 11.6%; Q3: 10.6%; Q4: 5.5%, p<0.001). In multivariate analysis, the only independent predictor of in-hospital mortality was Killip class >1 at admission. The independent predictors of long-term mortality were age ≥69.5 years, Killip class >1 at admission, diabetes mellitus, ST-segment depression on admission ECG and Hb <10.8g/dl.

DISCUSSION AND CONCLUSIONS

Low baseline hemoglobin is associated with more comorbidities and can accurately predict 1-year mortality after an acute coronary syndrome.

Authors+Show Affiliations

Serviço de Cardiologia, Hospitais da Universidade de Coimbra, Coimbra, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

por

PubMed ID

22244550

Citation

Ferreira, Muriel, et al. "[Hemoglobin: Simply a Laboratory Value or a Powerful Predictor of Risk in Patients With Acute Coronary Syndrome?]." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 31, no. 2, 2012, pp. 121-31.
Ferreira M, António N, Gonçalves F, et al. [Hemoglobin: simply a laboratory value or a powerful predictor of risk in patients with acute coronary syndrome?]. Rev Port Cardiol. 2012;31(2):121-31.
Ferreira, M., António, N., Gonçalves, F., Monteiro, P., Gonçalves, L., Freitas, M., & Providência, L. A. (2012). [Hemoglobin: simply a laboratory value or a powerful predictor of risk in patients with acute coronary syndrome?]. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 31(2), pp. 121-31. doi:10.1016/j.repc.2011.12.013.
Ferreira M, et al. [Hemoglobin: Simply a Laboratory Value or a Powerful Predictor of Risk in Patients With Acute Coronary Syndrome?]. Rev Port Cardiol. 2012;31(2):121-31. PubMed PMID: 22244550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hemoglobin: simply a laboratory value or a powerful predictor of risk in patients with acute coronary syndrome?]. AU - Ferreira,Muriel, AU - António,Natália, AU - Gonçalves,Francisco, AU - Monteiro,Pedro, AU - Gonçalves,Lino, AU - Freitas,Mário, AU - Providência,Luís Augusto, Y1 - 2012/01/11/ PY - 2011/01/28/received PY - 2011/09/08/accepted PY - 2012/1/17/entrez PY - 2012/1/17/pubmed PY - 2013/1/1/medline SP - 121 EP - 31 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 31 IS - 2 N2 - INTRODUCTION: Anemia has been shown to be associated with a worse prognosis, especially higher mortality in various pathological conditions. However, few studies have specifically examined its impact in acute coronary syndrome (ACS) patients. The purpose of our study was to assess the association between different quartiles of hemoglobin on admission and short- and long-term prognosis in patients with ACS. METHODS: We performed a retrospective analysis of 1303 consecutive ACS patients admitted to a coronary care unit and analyzed the association between baseline hemoglobin and morbidity and mortality, in-hospital and at 12-month follow-up. The population was divided into groups according to quartiles of hemoglobin concentration (Hb): Q1: <10.8g/dl; Q2: 10.8-12.2g/dl; Q3: 12.3-13.2g/dl; Q4: ≥13.3g/dl. Logistic regression analysis was used to identify independent predictors of short- and long-term mortality. RESULTS: Hypertension and diabetes mellitus were more common in the lower Hb quartiles, while the prevalence of smoking and physical inactivity increased with higher Hb. A higher proportion of patients in the lower quartiles had congestive heart failure, peripheral artery disease and previous stroke or transient ischemic attack. Anemic patients tended to be older, with worse renal function and left ventricular systolic function. Patients in Q1 had significantly higher levels of troponin I and blood glucose on admission. Anemic patients showed significantly higher in-hospital mortality (Q1: 9.8%; Q2: 6.3%; Q3: 4.1%; Q4: 3.6%, p<0.001), longer hospital stay (Q1: 6.1±4.4; Q2: 5.2±3.0; Q3: 4.9±2.7; Q4 4.3±2.1 days, p<0.001) and higher 1-year mortality (Q1: 23.6%; Q2: 11.6%; Q3: 10.6%; Q4: 5.5%, p<0.001). In multivariate analysis, the only independent predictor of in-hospital mortality was Killip class >1 at admission. The independent predictors of long-term mortality were age ≥69.5 years, Killip class >1 at admission, diabetes mellitus, ST-segment depression on admission ECG and Hb <10.8g/dl. DISCUSSION AND CONCLUSIONS: Low baseline hemoglobin is associated with more comorbidities and can accurately predict 1-year mortality after an acute coronary syndrome. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/22244550/[Hemoglobin:_simply_a_laboratory_value_or_a_powerful_predictor_of_risk_in_patients_with_acute_coronary_syndrome]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0870-2551(11)00111-9 DB - PRIME DP - Unbound Medicine ER -