心肌梗死后患者的血红蛋白水平与30天死亡率

Hemoglobin levels and 30-day mortality in patients after myocardial infarction.

作者信息

Lipsic Erik, van der Horst Iwan C C, Voors Adriaan A, van der Meer Peter, Nijsten Maarten W N, van Gilst Wiek H, van Veldhuisen Dirk J, Zijlstra Felix

机构信息

Department of Cardiology/Thorax Center, University Hospital Groningen, The Netherlands.

出版信息

Int J Cardiol. 2005 Apr 20;100(2):289-92. doi: 10.1016/j.ijcard.2004.10.043.

DOI:10.1016/j.ijcard.2004.10.043

PMID:15823637

Abstract

BACKGROUND

Anemia is an independent risk factor for cardiovascular (CV) outcomes in patients with coronary artery disease and heart failure. However, the effect of hemoglobin levels on short-term CV mortality in patients with acute myocardial infarction (MI) remains unclear.

METHODS

In a retrospective study we analyzed 1841 consecutive patients admitted with the diagnosis of acute MI. The primary end-point of the study was 30-day mortality. Patients were categorized according to the hemoglobin level on admission (10 g/dl or less, or greater than 10 g/dl).

RESULTS

The overall 30-day mortality was 10.3%. The mortality was 21.6% in patients with hemoglobin levels on admission < or =10 g/dl and 9.3% in patients with hemoglobin levels >10 g/dl (p<0.001). Multivariate logistic regression analysis showed, that lower hemoglobin concentration is an independent predictor of 30-day mortality, when adjusted for other risk factors (HR 1.76, CI 1.08-2.85; p=0.02).

CONCLUSIONS

Lower levels of hemoglobin are associated with higher short-term mortality in patients with acute MI. Specific therapeutic strategies in anemic patients with MI should be further considered.

摘要

背景

贫血是冠状动脉疾病和心力衰竭患者心血管（CV）预后的独立危险因素。然而，血红蛋白水平对急性心肌梗死（MI）患者短期CV死亡率的影响仍不明确。

方法

在一项回顾性研究中，我们分析了1841例连续诊断为急性MI的患者。该研究的主要终点是30天死亡率。根据入院时的血红蛋白水平（10g/dl或更低，或高于10g/dl）对患者进行分类。

结果

总体30天死亡率为10.3%。入院时血红蛋白水平≤10g/dl的患者死亡率为21.6%，血红蛋白水平>10g/dl的患者死亡率为9.3%（p<0.001）。多因素逻辑回归分析显示，在调整其他危险因素后，较低的血红蛋白浓度是30天死亡率的独立预测因素（HR 1.76，CI 1.08 - 2.85；p = 0.02）。