Aronson Doron, Suleiman Mahmoud, Agmon Yoram, Suleiman Abeer, Blich Miry, Kapeliovich Michael, Beyar Rafael, Markiewicz Walter, Hammerman Haim
Department of Cardiology, Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion, Haifa 31096, Israel.
Eur Heart J. 2007 Jun;28(11):1289-96. doi: 10.1093/eurheartj/ehm013. Epub 2007 Mar 15.
To study the prevalence and long-term prognostic significance of changes in haemoglobin levels during hospital course in survivors of acute myocardial infarction (AMI).
A prospective study involving 1390 patients who were admitted with AMI. Median follow-up was 24 months. Multivariable Cox models were used to evaluate the relationship between nadir and discharge haemoglobin and mortality after hospital discharge. Anaemia was present in 248 patients on admission (17.8%) and in 502 patients at discharge (36.1%). Nadir haemoglobin during hospital course was 1.3 g/dL lower (IQR 0.6-2.2) when compared with baseline haemoglobin (P < 0.0001). Low nadir haemoglobin and discharge haemoglobin were strongly associated with increased mortality. After adjusting for clinical variables and ejection fraction, the hazard ratios for a 1 g/dL decrease in nadir haemoglobin and discharge haemoglobin were 1.36 (95% CI 1.19-1.55; P < 0.0001) and 1.27 (95% CI 1.16-1.40; P < 0.0001), respectively.
The development of anaemia during hospitalization for AMI is frequent and is associated with an increased long-term mortality.
研究急性心肌梗死（AMI）幸存者住院期间血红蛋白水平变化的发生率及其长期预后意义。
一项前瞻性研究，纳入1390例因AMI入院的患者。中位随访时间为24个月。采用多变量Cox模型评估最低血红蛋白水平和出院时血红蛋白水平与出院后死亡率之间的关系。入院时248例患者存在贫血（17.8%），出院时502例患者存在贫血（36.1%）。与基线血红蛋白相比，住院期间最低血红蛋白水平低1.3 g/dL（四分位间距0.6 - 2.2）（P < 0.0001）。最低血红蛋白水平低和出院时血红蛋白水平低与死亡率增加密切相关。在对临床变量和射血分数进行校正后，最低血红蛋白水平和出院时血红蛋白水平每降低1 g/dL的风险比分别为1.36（95%可信区间1.19 - 1.55；P < 0.0001）和1.27（95%可信区间1.16 - 1.40；P < 0.0001）。
AMI住院期间贫血的发生很常见，且与长期死亡率增加相关。
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