Abnormal haemoglobin levels in acute coronary syndromes

Abstract

Abnormal haemoglobin levels were common in our ACS admissions. Anaemia was generally mild. Increasing age and interventional management were associated with anaemia, which in turn was associated with adverse in-hospital outcomes. Interventions to prevent and detect anaemia in this setting merit prospective testing.

Impact of Anemia on In-Hospital, One-Month and One-Year Mortality in Patients with Acute Coronary Syndrome from the Middle East

“…Anemia was present in 28% of the ACS patients studied confirming that anemia is frequently found in patients with ACS, although the prevalence varies widely between 10% to 30% depending on the definition used in various studies. [1][2][3][4][5][6][7][8][9] In accordance with the findings linking anemia and poor clinical outcomes in ACS patients, this study demonstrated that ACS patients with anemia were more likely to be older, female, and associated with comorbidities like diabetes, hypertension, chronic renal failure, and stroke; [1][2][3][4][5][6][7][8][9]18,19 thus identifying a high-risk population with poor hematopoetic reserve. They were more likely to present with lower systolic blood pressure, higher heart rates, and higher Killip class and GRACE risk scores.…”

“…One of the main findings of the present study is that admission anemia during ACS was not only related to statistically significant higher in-hospital mortality, 2,8,18 but also predicted 1-month 1,3,11,18 and 1-year mortality. [5][6][7]9,[23][24][25][26] The multiple regression models showed that this relationship persisted even after adjustment with GRACE risk score.…”

“…In this study, anemia <13 g/dL in men and <12 g/dL in women in a graded manner demonstrated increasing mortality, indicating that admission anemia per se (whether mild or severe) has a pronounced impact on survival in this MiddleEastern population. All the previous studies on this subject included a very defined subpopulation of patients with ACS and anemia [1][2][3][4][5][6][7][8][9] or included varying durations of follow-up, either 30-days or 1-year or more. This study demonstrated that admission anemia (WHO-defined) in all types of ACS at three levels of follow-up (in-hospital, 1-month and 1-year) was independently associated with increasing mortality.…”

“…[1][2][3][4][5][6][7][8][9] In addition, the need for blood transfusion due to anemia in the setting of ACS is associated with higher short-term mortality. 10 Furthermore, a low baseline hemoglobin level in ACS patients has been found to be an independent predictor of the risk of in-hospital major bleeding and risk of death and myocardial infarction at 30 days.…”

Serum Albumin Is Strongly Associated with Erythropoietin Sensitivity in Hemodialysis Patients

“…For example, malnutrition and inflammation can cause hypoalbuminemia and also suppress erythropoeisis (24). Furthermore, the relationship of albumin to hemoglobin is not limited to dialysis patients; albumin concentration is strongly associated with anemia in patients admitted to the hospital with acute coronary syndromes (25). Finally, drugs that reduce inflammation, such as statins, are associated with reduced epo requirements (26).…”