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Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units

Journal of Geriatric Cardiology 2020年第1期17卷 35-42页

作者： Victoria Lorente Jaime Aboal Cosme Garcia Jordi Sans-Rosello Antonia Sambola Rut Andrea Carlos Tomas gil Bonet David Vinas nabil el Ouaddi Santiago Montero Javier Cantalapiedra margarida Pujol Isabel Hernandez maria Perez-Rodriguez Isaac Llao Jose C Sanchez-Salado Miquel Gual Albert Ariza-Sole 无 Hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Hospital Unversitari Josep Trueta GironaSpain Hospital Universitari Germans Trias i Pujol Badalona BarcelonaSpain Hospital de la Santa Creu i Sant Pau Instituto de Investigación Biomedica IIB Sant PauUniversitat Autonoma de Barcelona(UAB)BarcelonaSpain Hospital Universitari de la Vall d’Hebron BarcelonaSpain Hospital Clinic i Provicial BarcelonaSpain Hospital Arnau de Vilanova LleidaSpain Hospital Joan XXIII TarragonaSpain the Grup de Treball de Cures Agudes Cardiologiques de la Societat Catalana de Cardiologia

Background Little information exists about the role of anemia in patients with acute coronary syndromes(ACS)admitted to Intensive Cardiac Care Units(ICCU).The aim of this study was to assess the prevalence of anemia and its impact on management and outcomes in this clinical setting.Methods All consecutive patients admitted to eight different ICCUs with diagnosis of non-ST segment elevation ACS(nSTEACS)were prospectively included.Anemia was defined as hemoglobinn men andn women.The association between anemia and mortality or readmission at six months was assessed by the Cox regression method.Results A total of 629 patients were included.Mean age was 66.6 years.A total of 197 patients(31.3%)had anemia.Coronary angiography was performed in most patients(96.2%).Patients with anemia were significantly older,with a higher prevalence of comorbidities,poorer left ventricle ejection fraction and higher GRACE score values.Patients with anemia underwent less often coronary angiography,but underwent more often intraaortic counterpulsation,non-invasive mechanical ventilation and renal replacement therapies.Both ICCU and hospital stay were significantly longer in patients with anemia.Both the incidence of mortality(HR=3.36,95%CI:1.43–7.85,P=0.001)and the incidence of mortality/readmission were significantly higher in patients with anemia(HR=2.80,95%CI:2.03–3.86,P=0.001).After adjusting for confounders,the association between anemia and mortality/readmission remained significant(P=0.031).Conclusions Almost one of three nSTEACS patients admitted to ICCU had anemia.Most patients underwent coronary angiography.Anemia was independently associated to poorer outcomes at 6 months.

关键词： Acute coronary syndromes Anemia Intensive cardiac care units Prognosis

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