Original ArticleImpact of Anaemia on Mortality and its Causes in Elderly Patients with Acute Coronary Syndromes
Introduction
Anaemia is a common comorbidity among patients with acute coronary syndromes (ACS) [1] and is associated with higher mortality in this clinical setting [2]. The exact mechanisms to explain this association remain unclear. Although anaemia may reduce oxygen delivery to the myocardium, thus increasing cardiovascular events, patients with anaemia are usually older, with more comorbidities that could also increase mortality due to non-cardiac diseases. Little information exists about cause specific mortality in ACS patients with anaemia.
On the other hand, frailty and comorbidities are common in elderly patients with ACS, making management and risk stratification difficult in this clinical scenario [3]. Information about the prognostic impact of anaemia in the elderly with ACS is scarce. The aim of the present study was to prospectively assess the impact of anaemia in overall mortality and its causes, in consecutive patients with ACS and also specifically in the elderly.
Section snippets
Study Design and Population
This is an observational single centre registry, which was conducted at a tertiary care Hospital in Spain (Hospital Universitari de Bellvitge, l’Hospitalet de Llobregat, Barcelona). All consecutive ACS patients admitted to the Coronary Care Unit between October 2009 and April 2014 were prospectively included. Informed consent was provided by all patients before their inclusion in the study. The confidential information of the patients was protected according to current national normative. This
Results
During the study period, 2128 ACS patients were admitted with mean age of 62.3 years. Almost 80% of patients were male. Table 1 shows baseline and clinical characteristics, management and clinical course of the overall cohort. Anaemia at admission was present in 497 patients (23.4%). Patients with anaemia were significantly older, with higher prevalence of cardiovascular risk factors and other comorbidities. Significant differences regarding clinical presentation were also found. Patents with
Discussion
The main findings from our study are: a) anaemia behaved as an independent predictor of mortality in our patients, and causes of mortality seem to be different regarding age subgroup, and b) the association between anaemia and mortality was not observed in elderly patients from our series.
Anaemia is a common comorbidity in ACS, and is strongly associated with higher mortality and morbidity in this setting [2], [9], [10], [11] and also in other diseases, such as heart failure [12] or kidney
Conclusions
Anaemia was a common comorbidity in elderly ACS patients from our series. The impact of anaemia on cause specific of mortality seems to be different according to age subgroup. We did not observe a significant association between anaemia and mortality in the elderly. Routine assessment of ageing related variables such as frailty and comorbidities may be useful to better understand the role of anaemia in risk stratification of elderly patients with ACS.
Disclosures
None declared.
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