BACKGROUND: Anemia is a common comorbidity among patients with acute coronary syndromes (ACS) and may adversely affect cardiovascular outcomes in these patients. We conducted a systematic review and meta-analysis to examine the association between anemia and mortality among patients with ACS. METHODS: We systematically searched MEDLINE to identify cohort studies and secondary analyses of randomized controlled trials examining the association between anemia and all-cause mortality among patients with ACS. Data were aggregated at 4 follow-up times (inhospital, 30 days, 1 year, and maximal available follow-up) using random-effects meta-analysis models. RESULTS: Twenty-seven studies met the inclusion criteria, involving 233,144 patients. Anemia was present in 44,519 (19.1%) of these patients. Anemic patients were generally older and had a higher prevalence of comorbidities including diabetes mellitus, congestive heart failure, cerebrovascular disease, and history of major bleeding. Anemia was associated with an increased risk of crude all-cause mortality (relative risk 2.08, 95% CI 1.70-2.55) and reinfarction (relative risk 1.25, 95% CI 1.02-1.53) at maximal available follow-up. When adjusted risk ratios from individual studies' multivariable regression analyses were pooled, the magnitude of the associated mortality risk was attenuated but remained significant at maximal follow-up (hazard ratio 1.49, 95% CI 1.23-1.81). Clinically and statistically significant increases in mortality were observed as early as at 30 days post-ACS and persisted at 1 year. CONCLUSIONS: Anemia in patients with ACS is independently associated with a significantly increased risk of early and late mortality.
BACKGROUND:Anemia is a common comorbidity among patients with acute coronary syndromes (ACS) and may adversely affect cardiovascular outcomes in these patients. We conducted a systematic review and meta-analysis to examine the association between anemia and mortality among patients with ACS. METHODS: We systematically searched MEDLINE to identify cohort studies and secondary analyses of randomized controlled trials examining the association between anemia and all-cause mortality among patients with ACS. Data were aggregated at 4 follow-up times (inhospital, 30 days, 1 year, and maximal available follow-up) using random-effects meta-analysis models. RESULTS: Twenty-seven studies met the inclusion criteria, involving 233,144 patients. Anemia was present in 44,519 (19.1%) of these patients. Anemicpatients were generally older and had a higher prevalence of comorbidities including diabetes mellitus, congestive heart failure, cerebrovascular disease, and history of major bleeding. Anemia was associated with an increased risk of crude all-cause mortality (relative risk 2.08, 95% CI 1.70-2.55) and reinfarction (relative risk 1.25, 95% CI 1.02-1.53) at maximal available follow-up. When adjusted risk ratios from individual studies' multivariable regression analyses were pooled, the magnitude of the associated mortality risk was attenuated but remained significant at maximal follow-up (hazard ratio 1.49, 95% CI 1.23-1.81). Clinically and statistically significant increases in mortality were observed as early as at 30 days post-ACS and persisted at 1 year. CONCLUSIONS:Anemia in patients with ACS is independently associated with a significantly increased risk of early and late mortality.
Authors: Alexander Thomas; Sean van Diepen; Rachel Beekman; Shashank S Sinha; Samuel B Brusca; Carlos L Alviar; Jacob Jentzer; Erin A Bohula; Jason N Katz; Andi Shahu; Christopher Barnett; David A Morrow; Emily J Gilmore; Michael A Solomon; P Elliott Miller Journal: JACC Adv Date: 2022-08-26
Authors: Patricia Wischmann; Raphael Romano Bruno; Bernhard Wernly; Georg Wolff; Shazia Afzal; Richard Rezar; Mareike Cramer; Nadia Heramvand; Malte Kelm; Christian Jung Journal: Eur Heart J Open Date: 2022-06-15
Authors: Richard Ofori-Asenso; Ella Zomer; Ken Lee Chin; Peter Markey; Si Si; Zanfina Ademi; Andrea J Curtis; Sophia Zoungas; Danny Liew Journal: Cardiovasc Diagn Ther Date: 2019-06