title: Usefulness of anemia in men as an independent predictor of two-year cardiovascular outcome in patients presenting with acute coronary syndrome.
abstract: Anemia has been shown to be an independent risk factor for the development of adverse cardiovascular outcomes in a variety of patient populations. In the case of patients presenting with acute coronary syndrome (ACS), anemia has been demonstrated to be a powerful and independent predictor of 30-day outcomes. However, there are limited and conflicting data about the long-term independent predictive value of anemia in patients with ACS. This is in contrast to non-ACS populations in which anemia has been shown to be an independent predictor of long-term outcomes. The present study investigated the long-term prognostic significance of anemia in a well-characterized cohort of 193 men with ACS who were referred for coronary angiography at a Veterans Affairs Medical Center. All patients were followed prospectively for the development of death or acute myocardial infarction (AMI), and follow-up data were available for all patients at 24 months. After controlling for a variety of baseline clinical, laboratory, and angiographic variables, hemoglobin (analyzed as a continuous variable and as a categorical variable using the World Health Organization cutoff of 13 g/dl for men) was a strong and independent predictor of the composite end point of death or AMI at 24 months when using a Cox proportional hazards model. At 24 months, the event-free survival was 64% in the group with a hemoglobin level < 13 g/dl compared with 81% in the group with a hemoglobin level > or = 13 g/dl (p = 0.0065 by log-rank test). In conclusion, these data demonstrate that baseline anemia is a strong and independent predictor of death or AMI at 2 years in patients with ACS.
authors.affiliation: Division of Cardiology, Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Erdal
authors.initials: E
authors.lastname: Cavusoglu
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Luther T
authors.initials: LT
authors.lastname: Clark
authors.forename: Calvin
authors.initials: C
authors.lastname: Eng
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Marmur
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications*; D017023:Coronary Angiography; D018572:Disease-Free Survival; D004562:Electrocardiography; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
chemical_list: D006454:Hemoglobins