TY - JOUR
T1 - Outcomes of anemic patients presenting with acute coronary syndrome
T2 - An analysis of the Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events
AU - Huynh, Ronald
AU - Hyun, Karice
AU - D'Souza, Mario
AU - Kangaharan, Nadarajah
AU - Shetty, Pratap C.
AU - Mariani, Justin
AU - Kilian, Jens
AU - Hung, Joseph
AU - Ryan, Mark
AU - Chew, Derek P.
AU - Brieger, David
PY - 2019/9/1
Y1 - 2019/9/1
N2 -
Background
Anemia commonly accompanies acute coronary syndromes
(ACS) and is associated with poorer outcomes. This study examines the
associations between anemia, management and outcomes in an Australian
ACS population.
Methods
This analysis of the CONCORDANCE database included
8665 ACS patients presenting to 41 Australian hospitals. Baseline
characteristics, management, and outcomes were compared between patients
with anemia (Hb ≤ 130 for males, Hb ≤ 120 g/L for females) and
non‐anemia.
Results
A total of 1880 (21.7%) patients presenting with ACS were anemic. These patients were older (72 years vs 63 years, P
< .0001), with higher prevalence of comorbidities. STEMI patients
with anemia were less likely to be emergently reperfused with either
thrombolytic therapy (22% vs 33%, P < .0001) or primary percutaneous coronary intervention (PCI) (45% vs 51% P = 0.033). For all ACS, anemic patients less frequently received: coronary angiography (63% vs 86%, P < .0001); drug eluting stents if undergoing PCI (50% vs 58%, P < .0001); dual antiplatelet therapy (80% vs 89%, P < .0001) ;and parenteral anticoagulants (82% vs 88%, P < .0001). In hospital complications of heart failure (20% vs 9%, P < .0001), renal failure (13% vs 4%, P < .0001), and re‐infarction (4% vs 2%, P =
.0006) were more common among anemic patients. There was a near‐linear
inverse relationship between admission hemoglobin and in hospital
mortality.
Conclusions
Anemic patients with ACS are a high risk group less
likely to undergo invasive and antithrombotic therapy. Further
investigation is required to determine if more active treatment of
anemic patients presenting with ACS will improve their outcomes.
AB -
Background
Anemia commonly accompanies acute coronary syndromes
(ACS) and is associated with poorer outcomes. This study examines the
associations between anemia, management and outcomes in an Australian
ACS population.
Methods
This analysis of the CONCORDANCE database included
8665 ACS patients presenting to 41 Australian hospitals. Baseline
characteristics, management, and outcomes were compared between patients
with anemia (Hb ≤ 130 for males, Hb ≤ 120 g/L for females) and
non‐anemia.
Results
A total of 1880 (21.7%) patients presenting with ACS were anemic. These patients were older (72 years vs 63 years, P
< .0001), with higher prevalence of comorbidities. STEMI patients
with anemia were less likely to be emergently reperfused with either
thrombolytic therapy (22% vs 33%, P < .0001) or primary percutaneous coronary intervention (PCI) (45% vs 51% P = 0.033). For all ACS, anemic patients less frequently received: coronary angiography (63% vs 86%, P < .0001); drug eluting stents if undergoing PCI (50% vs 58%, P < .0001); dual antiplatelet therapy (80% vs 89%, P < .0001) ;and parenteral anticoagulants (82% vs 88%, P < .0001). In hospital complications of heart failure (20% vs 9%, P < .0001), renal failure (13% vs 4%, P < .0001), and re‐infarction (4% vs 2%, P =
.0006) were more common among anemic patients. There was a near‐linear
inverse relationship between admission hemoglobin and in hospital
mortality.
Conclusions
Anemic patients with ACS are a high risk group less
likely to undergo invasive and antithrombotic therapy. Further
investigation is required to determine if more active treatment of
anemic patients presenting with ACS will improve their outcomes.
KW - acute coronary syndrome
KW - anemia
KW - anticoagulation
KW - antiplatelets
KW - percutaneous intervention
UR - http://www.scopus.com/inward/record.url?scp=85068011138&partnerID=8YFLogxK
U2 - 10.1002/clc.23219
DO - 10.1002/clc.23219
M3 - Article
C2 - 31216067
AN - SCOPUS:85068011138
VL - 42
SP - 791
EP - 796
JO - CLINICAL CARDIOLOGY
JF - CLINICAL CARDIOLOGY
SN - 0160-9289
IS - 9
ER -