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Relations of Anemia With the All-Cause Mortality and Cardiovascular Mortality in General Population: A Meta-Analysis
Zhou Liu1, Rong Sun2, Jianting Li3
1Department of Cardiology, Affiliated Hospital of Qinghai University, Xining, China.
Insights
Anemia increases the risk of all-cause mortality (ACM) and cardiovascular mortality (CVM). This meta-analysis confirms anemia as an independent predictor of death across diverse populations.
Area of Science:
- Cardiology
- Hematology
- Epidemiology
Background:
- Anemia is a potential independent risk factor for mortality.
- Understanding its impact on all-cause mortality (ACM) and cardiovascular mortality (CVM) is crucial for evidence-based medicine.
Purpose of the Study:
- To conduct a meta-analysis exploring the association between anemia and ACM/CVM.
- To provide evidence-based medical facts on anemia as a mortality risk factor.
Main Methods:
- Searched PubMed, Cochrane Library, and Embase databases up to October 2018.
- Included 15 relevant studies, screening based on strict inclusion/exclusion criteria.
- Calculated pooled hazard ratios (HRs) with 95% confidence intervals (CIs) to assess significance.
Main Results:
- Anemia significantly increased ACM (HR: 1.41, 95% CI: 1.33-1.50) and CVM (HR: 1.33, 95% CI: 1.23-1.45) in the general population.
- Increased ACM risk was observed across various age groups (over/under 65), sexes, and in patients with or without cardiovascular diseases (CVD).
- Specific HRs for ACM were: 1.43 (1.26-1.61) for >65 years, 1.41 (1.32-1.50) for <65 years, 1.39 (1.29-1.49) for males, 1.25 (1.20-1.30) for females, and 1.53 (1.39-1.68) for mixed sex.
Conclusions:
- Anemia is a significant risk factor for predicting ACM and CVM in the general population.
- This association is independent of sex, age, and a history of cardiovascular disease (CVD).
Background:
Anemia may be an independent risk factor of death. Therefore, the current meta-analysis aimed to explore the relationship of anemia with all-cause mortality (ACM) and cardiovascular mortality (CVM) to provide evidence-based medical facts.
Methods:
Three major electronic databases, the National Library of Medicine of the USA (PubMed), Cochrane Library and Embase, were searched from inception to October 2018. Relevant studies were screened in strict accordance with the inclusion and exclusion criteria, and the pooled hazard ratios (HRs) together with the 95% confidence intervals (CIs) were performed to assess the statistically significant difference of anemia compared with ACM and CVM.
Results:
A total of 15 related studies were included. Our results suggested that among the mixed population regardless of sex, age and cardiovascular diseases (CVD), the ACM and CVM of anemia patients were increased, with the HRs and 95% CIs of 1.41 (1.33, 1.50) and 1.33 (1.23, 1.45), respectively. Meanwhile, the ACM of anemia patients with the mean age of over 65 or below 65 years was increased irrespective of sex and CVD, with the HRs and 95% CIs of 1.43 (1.26, 1.61) and 1.41 (1.32, 1.50), separately. Moreover, the risks of ACM were increased in male, female and mixed sex anemia patients despite age and CVD, with the HRs and 95% CIs of 1.39 (1.29, 1.49), 1.25 (1.20, 1.30) and 1.53 (1.39, 1.68), respectively. All patients with CVD and no CVD were associated with an increased risk of ACM regardless of age and sex, with the HRs and 95% CIs of 1.42 (1.33, 1.51) and 1.38 (1.16, 1.63), respectively.
Conclusions:
Anemia is a risk factor to predict ACM and CVM among the general population, which is independent of sex, age, and history of CVD.
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