Lips̆ic E, Asselbergs F W, van der Meer P, Tio R A, Voors A A, van Gilst W H, Zijlstra F, van Veldhuisen D J
Neth Heart J. 2005 Aug;13(7-8):254-258.
Anaemia is an independent risk factor for cardiovascular (CV) events in patients with heart failure and patients with chronic kidney disease. The effect of anaemia on CV outcomes in patients with coronary artery disease (CAD) remains unclear. Therefore, we investigated the prognostic value of anaemia in this group of patients.
Patients with stable angina pectoris, referred for a first diagnostic coronary angiography, were eligible for this study. Only subjects with significant coronary artery disease (>50% luminal narrowing) were used for analysis (n=143). Cardiovascular events were defined as cardiovascular death, acute myocardial infarction and hospitalisation for unstable angina pectoris. Anaemia was defined according to WHO criteria as haemoglobin level ≤8 mmol/l in men and ≤7.5 mmol/l in women.
The mean age of the population was 61.5±9.4 years. During follow-up (44±19 months), 19 CV events occurred. The diagnosis of anaemia predicted CV events, even when adjusted for other risk factors (hazard ratio 5.73, 95% confidence interval 1.49-22.13, p=0.01). In univariate analysis, serum erythropoietin levels predicted CV outcomes (p<0.05); however, this association was lost when adjusted for haemoglobin concentration.
Anaemia is associated with worse outcome in patients with established CAD and could be used as a prognostic indicator in this group of patients.
贫血是心力衰竭患者和慢性肾病患者发生心血管（CV）事件的独立危险因素。贫血对冠状动脉疾病（CAD）患者心血管结局的影响仍不清楚。因此，我们研究了贫血在这类患者中的预后价值。
因首次诊断性冠状动脉造影而转诊的稳定型心绞痛患者符合本研究条件。仅将冠状动脉疾病严重（管腔狭窄>50%）的受试者纳入分析（n = 143）。心血管事件定义为心血管死亡、急性心肌梗死和因不稳定型心绞痛住院。根据世界卫生组织标准，贫血定义为男性血红蛋白水平≤8 mmol/l，女性血红蛋白水平≤7.5 mmol/l。
研究人群的平均年龄为61.5±9.4岁。在随访期间（44±19个月），发生了19起心血管事件。即使在对其他危险因素进行校正后，贫血诊断仍可预测心血管事件（风险比5.73，95%置信区间1.49 - 22.13，p = 0.01）。在单变量分析中，血清促红细胞生成素水平可预测心血管结局（p<0.05）；然而，在对血红蛋白浓度进行校正后，这种关联消失了。
贫血与已确诊CAD患者的不良结局相关，可作为这类患者的预后指标。
