Department of Cardiology, Medical University Vienna, Vienna, Austria.
Am J Cardiol. 2012 Dec 1;110(11):1699-703. doi: 10.1016/j.amjcard.2012.07.042. Epub 2012 Aug 23.
Anemia is associated with the cardiovascular outcome in healthy subjects but its impact on outcome in patients with cardiovascular disease has not yet been fully understood. Therefore, we assessed the long-term influence of hemoglobin on all-cause and cardiovascular mortality in patients with atherosclerotic disease. We prospectively studied 1,065 of 1,286 consecutive patients with asymptomatic carotid narrowing. During a median follow-up of 6.2 years, corresponding to 5,551 overall person-years, 275 patients (25.8%) died. Continuous measures of hemoglobin displayed a significant inverse effect on all-cause mortality and cardiovascular mortality (adjusted hazard ratio [HR] for increase of 1 SD of hemoglobin 0.73, 95% confidence interval [CI] 0.64 to 0.83; p <0.001) and adjusted HR 0.76, 95% CI 0.64 to 0.89; p = 0.001, respectively). The cumulative 6-year survival rate was 61%, 79%, 80%, and 81% in the first, second, third, and fourth quartile of hemoglobin (log-rank p <0.001). Patients within the first quartile (<12.9 g/dl) had a significantly increased risk of all-cause mortality (adjusted HR 1.93, 95% CI 1.46 to 2.54, p <0.001) and cardiovascular mortality (adjusted HR 1.68, 95% CI 1.19 to 2.36, p = 0.003) compared to patients with greater levels. In conclusion, our study has demonstrated a significant association with hemoglobin levels and all-cause and cardiovascular mortality in patients with carotid narrowing. Nevertheless, additional research, in terms of randomized controlled trials, is needed to warrant these findings and to evaluate potential therapeutic interventions.
贫血与健康受试者的心血管结局相关，但它对心血管疾病患者的结局的影响尚未完全了解。因此，我们评估了血红蛋白对动脉粥样硬化疾病患者全因和心血管死亡率的长期影响。我们前瞻性研究了 1286 例连续无症状颈动脉狭窄患者中的 1065 例。在中位随访 6.2 年（相当于 5551 人年）期间，275 例患者（25.8%）死亡。血红蛋白连续测量与全因死亡率和心血管死亡率呈显著负相关（血红蛋白增加 1 SD 的调整后的危害比为 0.73，95%置信区间为 0.64 至 0.83；p <0.001）和调整后的 HR 0.76，95%置信区间为 0.64 至 0.89；p = 0.001）。血红蛋白第一、二、三、四分位数的 6 年累积生存率分别为 61%、79%、80%和 81%（对数秩检验 p <0.001）。第一四分位数（<12.9 g/dl）的患者全因死亡率（调整后的 HR 1.93，95%置信区间为 1.46 至 2.54，p <0.001）和心血管死亡率（调整后的 HR 1.68，95%置信区间为 1.19 至 2.36，p = 0.003）显著高于其他水平的患者。总之，我们的研究表明，颈动脉狭窄患者的血红蛋白水平与全因和心血管死亡率显著相关。然而，需要进一步的研究，包括随机对照试验，以证明这些发现并评估潜在的治疗干预措施。
