Anemia adquirida en el síndrome coronario agudo. Predictores,pronóstico intrahospitalario y mortalidad a un año |
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Authors: | Oona Meroño Mercé Cladellas Lluis Recasens Cosme Garcia-Garcia Núria Ribas Victor Bazan Núria Farré Álvaro Sainz Josep Comin Jordi Bruguera |
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Institution: | 1. Servicio de Cardiología, Hospital Universitario del Mar, Barcelona, España;2. Doctorando en Medicina Interna, Universidad Autónoma de Barcelona, Barcelona, España |
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Abstract: | Introduction and objectivesAnemia at hospital admission predicts a poor outcome in patients presenting with acute coronary syndrome. It remains unclear whether in-hospital hemoglobin levels decrease (nosocomial anemia) not related to bleeding also implies a poor prognosis. We aimed to identify predictors of nosocomial anemia and its prognostic significance.MethodsWe prospectively included 221 acute coronary syndrome patients admitted in our institution during the years 2009-2010, with normal hemoglobin levels at admission. Nosocomial anemia was defined as a decrease in hemoglobin levels to <13 g/dL in men and <12 g/dL in women in the absence of apparent bleeding. Clinical variables and hematological inflammatory parameters were assessed in order to identify predictors for the development of nosocomial anemia. We compared the clinical outcome after a 1-year follow-up period of patients without anemia as opposed to those who developed nosocomial anemia.ResultsNosocomial anemia was registered in 25% of study patients. A >3.1 mg/dL value of C-reactive protein was highly predictive of developing nosocomial anemia (odds ratio=5.9; 95% confidence interval, 2.6-13.4; P<.001). The incidence of mortality and cardio-vascular morbidity was higher in the patients who developed nosocomial anemia (34.5% vs 9%; P<.001). Nosocomial anemia was a strong predictor of cardio-vascular morbidity and mortality in the long-term follow-up (hazard ratio=2.47; 95% confidence interval, 1.23-4.96; P=.01).ConclusionsNosocomial anemia predicts a poorer outcome in patients with acute coronary syndrome. Increased C-reactive protein levels, indicating inflammatory state, are predictive of developing in-hospital anemia unrelated to apparent bleeding.Full English text available from:www.revespcardiol.org |
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Keywords: | Hb hemoglobina PCR proteí na C reactiva SCA sí ndrome coronario agudo |
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