Anaemia is an independent predictor of mortality in patients with left ventricular systolic dysfunction following acute myocardial infarction

Nana Valeur, Olav Wendelboe Nielsen, John J V McMurray, Christian Torp-Pedersen, Lars Køber, TRACE Study Group

39 Citations (Scopus)

Abstract

BACKGROUND: In patients with chronic heart failure (HF), mortality is inversely related to haemoglobin (hgb) concentration. We investigated the prognostic importance of anaemia in patients with acute myocardial infarction (AMI) and left ventricular systolic dysfunction (LVSD) with and without HF.

METHODS AND RESULTS: We studied 1731 patients with AMI and left ventricular ejection fraction </=35% from the TRAndolapril Cardiac Evaluation (TRACE) study. Mild anaemia (110 g/L</=hgb<120 g/L in women and 120 g/L</=hgb<130 g/L in men) was present in 264 patients (15%), 114 (7%) had moderate (100 g/L</=hgb<110 g/L in women and 110 g/L</=hgb<120 g/L in men) and 59 (3%) had severe (hgb <100 g/L in women and <110 g/L in men) anaemia. According to the WHO criteria (hgb </=120 g/L in women and <130 g/L in men), 25% had anaemia. Anaemia was associated with increasing age, higher serum creatinine, lower body mass index, history of chronic HF, and worse NYHA class. In multivariable analyses including other prognostic factors only severe anaemia was associated with increased mortality, hazard ratio 1.59 (1.20-2.11). Anaemia was of prognostic importance in patients with HF, but not without HF. In HF patients the hazard ratios were 1.73 (1.26-2.36), 1.20 (0.93-1.56) and 1.05 (0.88-1.25) for severe, moderate and mild anaemia, respectively.

CONCLUSION: Anaemia is an independent predictor of mortality in patients with AMI and LVSD, but prognostic importance of anaemia is confined to the first year following AMI. The increased risk is driven by patients with severe anaemia and HF.

Original languageEnglish
JournalEuropean Journal of Heart Failure
Volume8
Issue number6
Pages (from-to)577-84
Number of pages8
ISSN1388-9842
DOIs
Publication statusPublished - Oct 2006
Externally publishedYes

Keywords

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia/etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction/complications
  • Prognosis
  • Retrospective Studies
  • Systole
  • Time Factors
  • Ventricular Dysfunction, Left/etiology

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