Coronary artery diseaseAnemia for Risk Assessment of Patients With Acute Coronary Syndromes
Section snippets
Methods
The study population was part of the Registre Franc Comtois des Syndromes Coronariens Aigus, an ongoing prospective ACS registry, that included all patients admitted for ACSs in any of the 10 cardiology centers in the region of Franche-Comté in Eastern France with a population of 1.2 million inhabitants. All patients gave informed consent. ACSs included ST-elevation myocardial infarction and non–ST-elevation myocardial infarction according to the European Society of Cardiology universal
Results
During 12 months (December 2005 to December 2006), 1,610 patients were admitted with a final diagnosis of acute myocardial infarction, 1,410 of whom had complete data and 30-day clinical follow-up. The distribution of hemoglobin was normal (Figure 1), with a mean of 13.5 ± 1.8 g/dl and median of 13.7 (interquartile range 12.4 to 14.8). Anemia was detected in 381 patients (27%).
Patients with anemia were older and had more previous co-morbidities, had more cardiovascular risk factors, and more
Discussion
Our data confirmed that anemia was an independent predictive factor for mortality, had incremental predictive value to the GRACE score system for early clinical outcomes, and allowed reclassification of a large proportion of patients into different risk categories.
The higher risk linked to anemia can be explained by the decrease in oxygen delivery to the myocardium18 and resulting increase in myocardial oxygen demand.19 Furthermore, it can be partially accounted for by patient characteristics.
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