Ariza-Solé Albert, Formiga Francesc, Salazar-Mendiguchía Joel, Garay Alberto, Lorente Victòria, Sánchez-Salado José C, Sánchez-Elvira Guillermo, Gómez-Lara Josep, Gómez-Hospital Joan A, Cequier Angel
Coronary Care Unit, Heart Diseases Institute, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Geriatrics Unit, Internal Medicine Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Heart Lung Circ. 2015 Jun;24(6):557-65. doi: 10.1016/j.hlc.2014.12.004. Epub 2014 Dec 24.
Prognostic impact of anaemia in the elderly with acute coronary syndromes has not been specifically analysed, and little information exists about causes of mortality in this setting.
We prospectively included consecutive patients with acute coronary syndromes. Anaemia was defined as haemoglobin < 130 g/L in men, and < 120 g/L in women. Primary outcome was mid-term mortality and its causes. Analyses were performed by Cox regression method.
We included 2128 patients, of whom 394 (18.6%) were aged 75 years or older. Anaemia was more common in the elderly (40.4% vs 19.5%, p <0.001). Mean follow-up was 386 days. Anaemia independently predicted overall mortality (HR 1.47, 95% CI 1.05-2.06), cardiac mortality (HR 1.76, 95% CI 1.06-2.94) and non-cardiac mortality (HR 1.59, 95% CI 1.03-2.45) in the overall cohort. In young patients the association between anaemia and mortality was significant only for non-cardiac causes. The association between anaemia and mortality was not significant in the elderly (HR 1.08, 95% CI 0.71-1.63, p 0.736).
The impact of anaemia on cause specific of mortality seem to be different according to age subgroup. The association between anaemia and mortality was not observed in elderly patients from our series.
老年急性冠脉综合征患者贫血的预后影响尚未得到具体分析,且关于此情况下的死亡原因信息较少。
我们前瞻性纳入了连续性急性冠脉综合征患者。贫血定义为男性血红蛋白<130 g/L,女性血红蛋白<120 g/L。主要结局是中期死亡率及其原因。采用Cox回归方法进行分析。
我们纳入了2128例患者,其中394例(18.6%)年龄在75岁及以上。贫血在老年人中更为常见(40.4%对19.5%,p<0.001)。平均随访386天。在整个队列中,贫血独立预测总体死亡率(HR 1.47,95%CI 1.05 - 2.06)、心脏死亡率(HR 1.76,95%CI 1.06 - 2.94)和非心脏死亡率(HR 1.59,95%CI 1.03 - 2.45)。在年轻患者中,贫血与死亡率之间的关联仅在非心脏原因方面具有显著性。在老年人中,贫血与死亡率之间的关联不显著(HR 1.08,95%CI 0.71 - 1.63,p 0.736)。
贫血对特定原因死亡率的影响似乎因年龄亚组而异。在我们的系列老年患者中未观察到贫血与死亡率之间的关联。