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Relationship between anemia and mortality outcomes in a national ACS cohort: insights from the UK MINAP registry

Mamas

Relationship between anemia and mortality outcomes in a national ACS cohort: insights from the UK MINAP registry Thumbnail


Authors



Abstract

Background
We aim to determine the prevalence of anemia in acute coronary syndrome (ACS) patients and compare their clinical characteristics, management, and clinical outcomes to those without anemia in an unselected national ACS cohort.

Methods and Results
The Myocardial Ischemia National Audit Project (MINAP) registry collects data on all adults admitted to hospital trusts in England and Wales with diagnosis of an ACS. We conducted a retrospective cohort study by analyzing patients in this registry between January 2006 and December 2010 and followed them up until August 2011. Multiple logistic regressions were used to determine factors associated with anemia and the adjusted odds of 30-day mortality with 1 g/dL incremental hemoglobin increase and the 30-day and 1-year mortality for anemic compared to nonanemic groups. Analyses were adjusted for covariates. Our analysis of 422 855 patients with ACS showed that 27.7% of patients presenting with ACS are anemic and that these patients are older, have a greater prevalence of renal disease, peripheral vascular disease, diabetes mellitus, and previous acute myocardial infarction, and are less likely to receive evidence-based therapies shown to improve clinical outcomes. Finally, our analysis suggests that anemia is independently associated with 30-day (OR 1.28, 95% CI 1.22-1.35) and 1-year mortality (OR 1.31, 95% CI 1.27-1.35), and we observed a reverse J-shaped relationship between hemoglobin levels and mortality outcomes.

Conclusions
The prevalence of anemia in a contemporary national ACS cohort is clinically significant. Patients with anemia are older and multimorbid and less likely to receive evidence-based therapies shown to improve clinical outcomes, with the presence of anemia independently associated with mortality outcomes.

Acceptance Date Oct 18, 2016
Publication Date Nov 19, 2016
Publicly Available Date Mar 29, 2024
Journal Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease
Print ISSN 2047-9980
Publisher Wiley Open Access
DOI https://doi.org/10.1161/JAHA.116.003348
Keywords acute coronary syndrome, anemia, mortality
Publisher URL http://dx.doi.org/10.1161/JAHA.116.003348