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Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center
BACKGROUND: Anemia on admission is a powerful predictor of major cardiovascular events in patients presenting for acute coronary syndromes. We sought to determine the prevalence and prognostic impact of anemia in patients presenting for ST-elevation myocardial infarction (STEMI). METHODS: We analyze...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475353/ https://www.ncbi.nlm.nih.gov/pubmed/28652668 http://dx.doi.org/10.1016/j.jsha.2016.10.003 |
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author | Jomaa, Walid Ben Ali, Imen Hamdi, Sonia Azaiez, Mohamed A. Hraïech, Aymen El Ben Hamda, Khaldoun Maatouk, Faouzi |
author_facet | Jomaa, Walid Ben Ali, Imen Hamdi, Sonia Azaiez, Mohamed A. Hraïech, Aymen El Ben Hamda, Khaldoun Maatouk, Faouzi |
author_sort | Jomaa, Walid |
collection | PubMed |
description | BACKGROUND: Anemia on admission is a powerful predictor of major cardiovascular events in patients presenting for acute coronary syndromes. We sought to determine the prevalence and prognostic impact of anemia in patients presenting for ST-elevation myocardial infarction (STEMI). METHODS: We analyzed data from a Tunisian retrospective single center STEMI registry. Patients were enrolled between January 1998 and October 2014. Anemic and nonanemic patients were compared for clinical and prognostic features and according to four prespecified hemoglobin level subgroups. In patients with severe anemia, factors associated with in-hospital death were studied. RESULTS: A total of 1498 patients were enrolled. Mean age was 60.47 ± 12.7 years and prevalence of anemia was 36.6%. Anemic patients were more likely to be elderly, hypertensive, and diabetic in comparison to nonanemic patients. In-hospital mortality was significantly higher in anemic patients (14.9% vs. 5%, p < 0.001). Lower hemoglobin levels were significantly associated with a higher prevalence of heart failure on admission, cardiogenic shock, and in-hospital mortality (p < 0.001 for all). In univariate analysis, factors associated with in-hospital death in patients with severe anemia were hypertension (p = 0.044), heart failure on admission (p < 0.001), renal failure on admission (p < 0.001), and primary percutaneous coronary intervention (pPCI) use (p = 0.016). The absence of pPCI use was independently associated with in-hospital death in multivariate analysis (odds ratio = 2.22, 95% confidence interval: 1.07–4.76, p = 0.033). CONCLUSION: According to this study, anemic patients presenting for STEMI have a higher in-hospital mortality rate. The absence of pPCI use was independently associated with in-hospital death. |
format | Online Article Text |
id | pubmed-5475353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-54753532017-06-26 Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center Jomaa, Walid Ben Ali, Imen Hamdi, Sonia Azaiez, Mohamed A. Hraïech, Aymen El Ben Hamda, Khaldoun Maatouk, Faouzi J Saudi Heart Assoc Full Length Article BACKGROUND: Anemia on admission is a powerful predictor of major cardiovascular events in patients presenting for acute coronary syndromes. We sought to determine the prevalence and prognostic impact of anemia in patients presenting for ST-elevation myocardial infarction (STEMI). METHODS: We analyzed data from a Tunisian retrospective single center STEMI registry. Patients were enrolled between January 1998 and October 2014. Anemic and nonanemic patients were compared for clinical and prognostic features and according to four prespecified hemoglobin level subgroups. In patients with severe anemia, factors associated with in-hospital death were studied. RESULTS: A total of 1498 patients were enrolled. Mean age was 60.47 ± 12.7 years and prevalence of anemia was 36.6%. Anemic patients were more likely to be elderly, hypertensive, and diabetic in comparison to nonanemic patients. In-hospital mortality was significantly higher in anemic patients (14.9% vs. 5%, p < 0.001). Lower hemoglobin levels were significantly associated with a higher prevalence of heart failure on admission, cardiogenic shock, and in-hospital mortality (p < 0.001 for all). In univariate analysis, factors associated with in-hospital death in patients with severe anemia were hypertension (p = 0.044), heart failure on admission (p < 0.001), renal failure on admission (p < 0.001), and primary percutaneous coronary intervention (pPCI) use (p = 0.016). The absence of pPCI use was independently associated with in-hospital death in multivariate analysis (odds ratio = 2.22, 95% confidence interval: 1.07–4.76, p = 0.033). CONCLUSION: According to this study, anemic patients presenting for STEMI have a higher in-hospital mortality rate. The absence of pPCI use was independently associated with in-hospital death. Elsevier 2017-07 2016-10-20 /pmc/articles/PMC5475353/ /pubmed/28652668 http://dx.doi.org/10.1016/j.jsha.2016.10.003 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Full Length Article Jomaa, Walid Ben Ali, Imen Hamdi, Sonia Azaiez, Mohamed A. Hraïech, Aymen El Ben Hamda, Khaldoun Maatouk, Faouzi Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title | Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title_full | Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title_fullStr | Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title_full_unstemmed | Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title_short | Prevalence and prognostic significance of anemia in patients presenting for ST-elevation myocardial infarction in a Tunisian center |
title_sort | prevalence and prognostic significance of anemia in patients presenting for st-elevation myocardial infarction in a tunisian center |
topic | Full Length Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475353/ https://www.ncbi.nlm.nih.gov/pubmed/28652668 http://dx.doi.org/10.1016/j.jsha.2016.10.003 |
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