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Long-term prognostic impact of anemia in patients with ST-elevation acute myocardial infarction treated by primary coronary angioplasty

Introduction

Anemia has been shown to be a powerful and independent predictor of 30-day outcomes among patients presenting with acute coronary syndrome. However, there are limited and conflicting data about its long-term independent predictive value in this setting.

Objectives

To investigate the long-term prognostic impact of anemia in patients with ST-elevation acute myocardial infarction (STEMI) treated by primary coronary angioplasty (PCA).

Methods

Retrospectively, from January 2001 to December 2003, we studied 298 consecutive patients with STEMI treated with PCA. Patients were classified into two groups according to having anemia or nonanemia at admission (for men Hb < 13 vs ≥ 13 g/dl, and for women Hb < 12 vs ≥ 12 g/dl). We defined the composite endpoint as death or rehospitalization for heart failure or acute coronary event. The average follow-up time was 24 months and was determined in 97%.

Results

Anemia was present in 41 patients (14%). At the end of follow-up, 109 patients (37%) developed ≥ 1 component of the composite endpoint (52 deaths and 66 rehospitalization). The event-free survival was 62% in the group with anemia versus 82% in the other group (P < 0.001). After controlling for a variety of baseline clinical, laboratory, and angiographic variables, anemia was a strong and independent predictor of death or rehospitalization for heart failure or acute coronary event (HR 1.96, 95% CI 1.21–3.17, P = 0.006). Figure 1 shows that patients with anemia present a worse prognosis.

figure1

Figure 1

Conclusion

Our data demonstrate that baseline anemia is a strong and independent predictor of future adverse events at 2 years in patients with STEMI treated with PCA.

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Assi, E.A., Soto, F., Vidal, R. et al. Long-term prognostic impact of anemia in patients with ST-elevation acute myocardial infarction treated by primary coronary angioplasty. Crit Care 11, P236 (2007). https://doi.org/10.1186/cc5396

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Keywords

  • Heart Failure
  • Myocardial Infarction
  • Anemia
  • Independent Predictor
  • Emergency Medicine