Changes in haemoglobin levels during hospital course and long-term outcome after acute myocardial infarction.
OBJECTIVE
To study the prevalence and long-term prognostic significance of changes in haemoglobin levels during hospital course in survivors of acute myocardial infarction (AMI).


RESULTS
A prospective study involving 1390 patients who were admitted with AMI. Median follow-up was 24 months. Multivariable Cox models were used to evaluate the relationship between nadir and discharge haemoglobin and mortality after hospital discharge. Anaemia was present in 248 patients on admission (17.8%) and in 502 patients at discharge (36.1%). Nadir haemoglobin during hospital course was 1.3 g/dL lower (IQR 0.6-2.2) when compared with baseline haemoglobin (P < 0.0001). Low nadir haemoglobin and discharge haemoglobin were strongly associated with increased mortality. After adjusting for clinical variables and ejection fraction, the hazard ratios for a 1 g/dL decrease in nadir haemoglobin and discharge haemoglobin were 1.36 (95% CI 1.19-1.55; P < 0.0001) and 1.27 (95% CI 1.16-1.40; P < 0.0001), respectively.


CONCLUSIONS
The development of anaemia during hospitalization for AMI is frequent and is associated with an increased long-term mortality.
Aronson
Doron
D
Department of Cardiology, Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion, Haifa 31096, Israel. daronson@techunix.technion.ac.il
Suleiman
Mahmoud
M
Agmon
Yoram
Y
Suleiman
Abeer
A
Blich
Miry
M
Kapeliovich
Michael
M
Beyar
Rafael
R
Markiewicz
Walter
W
Hammerman
Haim
H
D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000401:mortality; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006470:Hemorrhage / Q000097:blood / Q000209:etiology / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016019:Survival Analysis
D006454:Hemoglobins