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Prognostic relevance of normocytic anemia in elderly patients affected by cardiovascular disease

Journal of Geriatric Cardiology 2021年第8期18卷 654-662页

作者： Liana Spazzafumo Fabiola Olivieri Jacopo Sabbatinelli Roberta Galeazzi Rina Recchioni fiorella marcheselli Paola Tamburrini Roberto Antonicelli Epidemiologic Observatory Regional Health AgencyRegione MarcheAnconaItaly Department of Clinical and Molecular Sciences UniversitàPolitecnica delle MarcheAnconaItaly Center of Clinical Pathology and Innovative Therapy Italian National Research Centre on AgingIRCCS INRCAAnconaItaly SOD Medicina di Laboratorio Azienda Ospedaliero Universitaria Ospedali RiunitiAnconaItaly Clinical Laboratory and Molecular Diagnostic Italian National Research Center on AgingIRCCS INRCAAnconaItaly Department of Cardiology-CCU Italian National Research Centre on AgingIRCCS INRCAAnconaItaly

BACKGROUND Anemia associated with cardiovascular diseases(CVD) is a common condition in older persons. Prevalence and prognostic role of anemia were extensively studied in patients with myocardial infarction(MI) or congestive heart failure(CHF) whereas limited data were available on patients with atrial fibrillation(AF). This study was conducted to assess the clinical prevalence and prognostic relevance of anemia in elderly patients affected by AF and other *** A total of 866 elderly patients(430 men and 436 women, age: 65-98 years, mean age: 85 ± 10 years) were *** these patients, 267 patients had acute non-ST-segment elevation MI(NSTEMI), 176 patients had acute CHF, 194 patients had acute AF and 229 patients were aged-matched healthy persons(CTR). All parameters were measured at the hospital admission and cardiovascular mortality was assessed during twenty-four months of *** The prevalence of anemia was higher in NSTEMI, CHF and AF patients compared to CTR subjects(50% vs. 15%, P <0.05), with normocytic anemia being the most prevalent type(90%). Adjusted mortality risk was higher in anemic patient versus non-anemic patient in all the groups of patients [NSTEMI: hazard ratio(HR) = 1.81, 95% CI: 1.06-2.13;CHF: HR = 2.49, 95% CI:1.31-4.75;AF: HR = 1.98, 95% CI: 1.01-3.88]. Decreased hemoglobin levels(P = 0.001) and high reticulocyte index(P = 0.023) were associated with higher mortality in CVD *** The significant associations between CVD and anemia and the prognostic relevance of anemia for elderly patients with CVD were confirmed in this study. The presence of anemia in AF patients is associated with a two-fold increased mortality risk compared with non-anemic AF patients. Low hemoglobin and high reticulocyte count independently predict mortality in elderly patients with CVD.

关键词： patients anemia cardiovascular

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