TY - JOUR
T1 - Hemoglobin nonrecovery following acute myocardial infarction is a biomarker of poor outcome
T2 - A retrospective database study
AU - Leshem-Rubinow, Eran
AU - Steinvil, Arie
AU - Rogowski, Ori
AU - Zeltser, David
AU - Berliner, Shlomo
AU - Weitzman, Dahlia
AU - Raz, Raanan
AU - Chodick, Gabriel
AU - Shalev, Varda
PY - 2013/11/20
Y1 - 2013/11/20
N2 - Background Anemia on admission and during hospitalization is associated with poor short and long term prognosis among patients with acute coronary syndrome (ACS). Our objective was to examine the prognostic implications of longitudinal hemoglobin (Hb) levels following a first acute myocardial infarction (AMI). Methods We utilized data obtained from the computerized database of a large community based health care maintenance organization to identify patients who survived for at least 6 months following a first AMI, during the years 2003-2010. Hazard ratios were calculated using Cox proportional regression models with various Hb measurements as dependent variables, and net reclassification improvement (NRI) was applied to evaluate the prognostic usefulness of these Hb measurements. Results Last Hb measurement during a 6-24 month follow-up period was found to have the highest prognostic power. In males, Hb levels below 13 g/dL were gradually associated with a higher risk of events, reaching a HR of 4.13 at Hb levels < 11 g/dL. In females, only Hb levels lower than 11 g/dL were significantly associated with a higher event rate (HR = 2.42, p = 0.003). Hb decrease was significantly associated with an increased risk in both genders, even among non-anemic patients at baseline. Conclusions Anemia and Hb decrement following a first AMI are associated with worse prognosis and elevated risk of combined all cause mortality and recurrent cardiac events.
AB - Background Anemia on admission and during hospitalization is associated with poor short and long term prognosis among patients with acute coronary syndrome (ACS). Our objective was to examine the prognostic implications of longitudinal hemoglobin (Hb) levels following a first acute myocardial infarction (AMI). Methods We utilized data obtained from the computerized database of a large community based health care maintenance organization to identify patients who survived for at least 6 months following a first AMI, during the years 2003-2010. Hazard ratios were calculated using Cox proportional regression models with various Hb measurements as dependent variables, and net reclassification improvement (NRI) was applied to evaluate the prognostic usefulness of these Hb measurements. Results Last Hb measurement during a 6-24 month follow-up period was found to have the highest prognostic power. In males, Hb levels below 13 g/dL were gradually associated with a higher risk of events, reaching a HR of 4.13 at Hb levels < 11 g/dL. In females, only Hb levels lower than 11 g/dL were significantly associated with a higher event rate (HR = 2.42, p = 0.003). Hb decrease was significantly associated with an increased risk in both genders, even among non-anemic patients at baseline. Conclusions Anemia and Hb decrement following a first AMI are associated with worse prognosis and elevated risk of combined all cause mortality and recurrent cardiac events.
KW - Acute myocardial infarction
KW - Anemia
KW - Hemoglobin
UR - http://www.scopus.com/inward/record.url?scp=84888001854&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2013.09.004
DO - https://doi.org/10.1016/j.ijcard.2013.09.004
M3 - مقالة
C2 - 24182909
SN - 0167-5273
VL - 169
SP - 349
EP - 353
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 5
ER -