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Impact of Anemia on Long-Term Outcomes and Mortality in ST-Segment Elevation Myocardial Infarction Patients: A
Masoumeh Sadeghi1, Fatereh Baharlouei Yancheshmeh2, Azam Soleimani3
1Department of Cardiology, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Anemia significantly increases 3-year mortality and cardiovascular event risk in ST-Elevation Myocardial Infarction (STEMI) patients. Early identification and management of anemia are crucial for improving outcomes in myocardial infarction survivors.
Area of Science:
- Cardiology
- Hematology
- Clinical Research
Background:
- Investigating the impact of hemoglobin (Hb) levels on patient outcomes after myocardial infarction (MI).
- Assessing the relationship between anemia and clinical outcomes in ST-Elevation Myocardial Infarction (STEMI) patients.
Purpose of the Study:
- To evaluate the effect of hemoglobin levels on 3-year clinical outcomes.
- To determine the association between anemia and long-term cardiovascular-related mortality in MI patients.
Main Methods:
- Secondary analysis of the ST Elevation Myocardial Infarction Cohort Study (SEMI-CI) including 844 STEMI patients.
- Recording Hb levels and clinical data at admission and annually for 3 years.
- Utilizing Cox regression analyses to identify hazard ratios for cardiovascular disease (CVD) events.
Main Results:
- Anemia prevalence was 16.7%, associated with increased risk of composite events (HR: 2.38) and mortality (HR: 2.91) in 3-year follow-up.
- After adjusting for covariates, anemia remained linked to higher composite event and mortality risks.
- Non-anemic patients demonstrated significantly better 3-year cardiovascular survival (P < 0.0001).
Conclusions:
- Anemia is linked to increased 3-year mortality in STEMI patients, particularly within the first year.
- Associations were observed between anemia and composite CVD events and unstable angina in long-term follow-ups.
- Findings highlight the importance of considering anemia in the management of STEMI patients.
Background:
This study aimed to evaluate the effect of hemoglobin (Hb) levels on 3-year clinical outcomes and long-term cardiovascular-related mortality in MI patients.
Methods:
This study is a secondary study of the ST Elevation Myocardial Infarction Cohort Study (SEMI-CI) in Isfahan, Iran, that included 844 STEMI patients. The Hb level and other clinical and biochemical data during hospitalization were recorded at admission and also for 3 years annually. Cox regression analyses (univariate and multivariate) were performed to identify hazard ratios for CVD events.
Results:
The prevalence of anemia was 16.7% in our population. Anemia was associated with an increased risk of the composite event (HR: 2.38, 95% CI: 1.77-3.19), mortality (HR: 2.91, 95% CI: 2.03-4.15), and unstable angina (HR: 2.22, 95% CI: 1.07-4.58) during a 3-year follow-up. After adjusting factors including smoking, diabetes, hypercholesterolemia, atrial fibrillation, treated hypertension, and BMI, anemia was only associated with an increased risk of the composite event and mortality. The 3-year cardiovascular survival curve showed better results in the nonanemic group (P value < 0.0001).
Conclusions:
Anemia was associated with a higher prevalence of 3-year mortality in STEMI patients, especially in the first year. In addition, there were associations between anemia and some CVD events in long-term follow-ups such as composite CVD events and unstable angina in our population.
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