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ST 段抬高型心肌梗死患者的既往和新发贫血:不同的预后作用?

Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

机构信息

Heart and Vessel Department, Intensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy.

出版信息

Intern Emerg Med. 2011 Aug;6(4):329-36. doi: 10.1007/s11739-010-0494-2. Epub 2010 Dec 8.

DOI:10.1007/s11739-010-0494-2
PMID:21140239
Abstract

The present investigation, performed in 1,122 consecutive STEMI patients treated with primary coronary intervention, was aimed at evaluating: (1) the prevalence of prior anemia and its prognostic significance in the short term; and (2) the prevalence of new anemia and its impact in the short term. The prevalence of prior anemia was 27.4%. Patients with a prior anemia were older and exhibited a higher incidence of chronic diseases and comorbidities. They showed a higher intra-hospital mortality rate (p < 0.001), a higher incidence of PCI failure (p < 0.001) and major bleedings (p < 0.001). Prior anemia was an independent predictor for intra-hospital mortality (OR 2.12; 95% CI 1.21-3.70, p = 0.009). Patients with a new anemia account for 46.8% of our series, and showed a higher early mortality rate and incidence of major bleedings in respect to those who maintained normal Hb values (p < 0.05 and <0.05, respectively). our data strengthens the prognostic role of Hb values in STEMI patients submitted to primary PCI, since the presence of prior anemia identified a subset of patients, characterized by advanced age, higher comorbidities and serious coronary artery disease, at higher risk for intra ICCU mortality and complications. Moreover, the development of anemia during an ICCU stay is common, and is associated with a higher mortality rate and incidence of complications in respect to patients who maintain normal Hb values.

摘要

本研究在 1122 例接受直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者中进行,旨在评估:(1)既往贫血的患病率及其短期预后意义;(2)新发贫血的患病率及其短期影响。既往贫血的患病率为 27.4%。既往贫血患者年龄较大,且患有更多的慢性疾病和合并症。他们的院内死亡率更高(p<0.001),PCI 失败率(p<0.001)和大出血发生率更高(p<0.001)。既往贫血是院内死亡率的独立预测因素(OR 2.12;95%CI 1.21-3.70,p=0.009)。新发贫血患者占本研究系列的 46.8%,与维持正常 Hb 值的患者相比,早期死亡率和大出血发生率更高(p<0.05 和 p<0.05)。我们的数据强化了 Hb 值在接受直接 PCI 的 STEMI 患者中的预后作用,因为既往贫血确定了一组患者,这些患者年龄较大,合并症更多,严重冠状动脉疾病,院内死亡率和并发症的风险更高。此外,在 ICU 住院期间发生贫血很常见,与维持正常 Hb 值的患者相比,死亡率和并发症发生率更高。

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Plasma glucose and not hemoglobin or renal function predicts mortality in patients with STEMI complicated with cardiogenic shock.血浆葡萄糖而非血红蛋白或肾功能可预测合并心原性休克的 STEMI 患者的死亡率。
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Impact of hypertension on short- and long-term prognoses in patients with ST elevation myocardial infarction and without previously known diabetes.高血压对ST段抬高型心肌梗死且既往无糖尿病患者短期和长期预后的影响
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