[贫血对非洲黑人心肌梗死预后的影响]

[Impact of anaemia on the prognosis of myocardial infarction in black Africans].

作者信息

Konin C, Adoh M, Koffi J, Anzouan-Kacou J B, Adoubi A, Kramoh E, Ake-Traboulsy E

机构信息

Cardiology Institute of Abidjan and University of Cocody, Abidjan, Ivory Coast.

出版信息

Cardiovasc J Afr. 2009 Jul-Aug;20(4):245-50.

PMID:19701537

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3721681/

Abstract

OBJECTIVE

Anaemia is increasingly being described as a negative predictor of outcome after myocardial infarction. The objective of our study was to assess the prognosis post myocardial infarction in the short and medium term in black Africans with chronic anaemia.

METHODS

We carried out a comparative case-control study on 272 patients (93 anaemic and 179 non-anaemic) hospitalised for myocardial infarction at the Cardiology Institute of Abidjan. One group included 93 patients who presented with anaemia concurrent with the myocardial infarction (haemoglobin level low: 13 g/dl for males and 12 g/dl for females, respectively). The other group comprised 172 patients who presented without anaemia during the acute phase of myocardial infarction. The haemoglobin rate was measured at admission, as were the biological markers of myocardial infarction.

RESULTS

The mean age was 53.5 years for the anaemic patients and 52.6 years for the non-anaemic patients. We noticed a clear male predominance in both populations (81.7 vs 78.8%; p = 0.56). The mean haemoglobin level was lower in the anaemic patients compared to that in the non-anaemic patients (10.2 vs 15 g/dl). The anaemic patients were eight times more at risk for an unfavourable outcome (complications or death) compared to the non-anaemic patients (91.4 vs 57%; OR = 8.02; 95% CI: 3.5-19.07; chi(2) = 33.74; p < 0.0001). The anaemic patients were 3.7 times more at risk for right ventricular failure (NYHA class II and III) compared to the control population (69.9 vs 38.5%; OR = 3.7; 95% CI: 08-6.60; chi(2) = 24.06; p < 0.0001) and six times more at risk for cardiogenic shock (24.7 vs 5.3%; OR = 6.21; 95% CI: 2.56-15.43; chi(2) = 22.89; p < 0.0001). The mortality rate was significantly higher in the anaemic than the non-anaemic patients (35.5 vs 12.8%; OR = 3.73; 95% CI: 1.94-7.19; chi(2) = 19.18; p < 0.0001).

CONCLUSION

Anaemia is an independent risk factor for a poor prognosis during the acute phase of myocardial infarction in black Africans.

摘要

目的

贫血越来越多地被描述为心肌梗死后预后不良的一个预测因素。我们研究的目的是评估患有慢性贫血的非洲黑人在心肌梗死后短期和中期的预后情况。

方法

我们对在阿比让心脏病研究所住院治疗心肌梗死的272例患者（93例贫血患者和179例非贫血患者）进行了一项比较性病例对照研究。一组包括93例在心肌梗死同时伴有贫血的患者（血红蛋白水平低：男性分别为<13 g/dl，女性分别为<12 g/dl）。另一组由172例在心肌梗死急性期无贫血表现的患者组成。入院时测量血红蛋白率以及心肌梗死的生物学标志物。

结果

贫血患者的平均年龄为53.5岁，非贫血患者为52.6岁。我们注意到两组人群中男性均占主导（81.7%对78.8%；p = 0.56）。贫血患者的平均血红蛋白水平低于非贫血患者（10.2 g/dl对15 g/dl）。与非贫血患者相比，贫血患者出现不良结局（并发症或死亡）的风险高8倍（91.4%对57%；OR = 8.02；95% CI：3.5 - 19.07；χ(2)= 33.74；p < 0.0001）。与对照组相比，贫血患者发生右心室衰竭（纽约心脏协会II级和III级）的风险高3.7倍（69.9%对38.5%；OR = 3.7；95% CI：08 - 6.60；χ(2)= 24.06；p < 0.0001），发生心源性休克的风险高6倍（24.7%对5.3%；OR = 6.21；95% CI：2.56 - 15.43；χ(2)= 22.89；p < 0.0001）。贫血患者的死亡率显著高于非贫血患者（35.5%对12.8%；OR = 3.73；95% CI：1.94 - 7.19；χ(2)= 19.18；p < 0.0001）。