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贫血及获得性贫血对急性冠状动脉综合征患者院内死亡率的影响

Impact of Anemia and Acquired Anemia on in-Hospital Mortality of Acute Coronary Syndrome Patients.

作者信息

Yakut Idris, Dervis Emir

机构信息

Department of Cardiology, Medipol Istanbul University Faculty of Medicine, Istanbul, Turkey.

出版信息

Int J Gen Med. 2024 Dec 24;17:6431-6442. doi: 10.2147/IJGM.S493385. eCollection 2024.

Abstract

OBJECTIVE

To investigate the associations of anemia-related parameters, with in-hospital mortality after acute coronary syndrome (ACS), as well as factors associated with prior anemia (PA) and hospital-acquired anemia (HAA) in patients with ACS.

METHODS

This was a retrospective cohort study conducted between June 2021 and May 2023. The data of patients diagnosed with ACS who were hospitalized and treated in our hospital were recorded, including age and sex, smoking and comorbidity status, laboratory findings, CHA2DS2-VASc scores, prior medication use, left ventricular ejection fraction, ACS type, the synergy between percutaneous intervention with taxus drug-eluting stents and cardiac surgery (SYNTAX) scores, stent thrombosis status and mortality status. Mortality was assessed according to in-hospital death. Patients were grouped based on anemia presence (PA and HAA).

RESULTS

A total of 329 patients were included in the study. Of these, 219 (66.56%) were in the no anemia group, 58 (17.63%) in the PA group, and 52 (15.81%) in the HAA group. The mean age of all participants was 61.27±12.45 years and 76.29% of them were male. 14 (4.26%) patients died during hospitalization. Multivariable logistic regression analysis had revealed that, prior coronary artery disease (OR: 3.779, 95% CI: 1.141-12.508, 0.030), PA (OR: 7.043, 95% CI: 1.574-31.517, 0.011), HAA (OR: 5.857, 95% CI: 1.260-27.236, 0.024) and high WBC (OR: 1.190, 95% CI: 1.028-1.378, 0.020) were independently associated with the increased risk of in-hospital mortality.

CONCLUSION

Consequently, the risk of in-hospital mortality is higher in patients with a previous history of coronary artery disease, PA, HAA and high WBC, and additional precautions should be taken in these patients.

摘要

目的

探讨贫血相关参数与急性冠状动脉综合征(ACS)患者院内死亡率的关系,以及ACS患者既往贫血(PA)和医院获得性贫血(HAA)的相关因素。

方法

这是一项于2021年6月至2023年5月进行的回顾性队列研究。记录了我院收治并接受治疗的诊断为ACS患者的数据,包括年龄和性别、吸烟和合并症状况、实验室检查结果、CHA2DS2-VASc评分、既往用药情况、左心室射血分数、ACS类型、紫杉醇药物洗脱支架经皮介入与心脏手术的协同作用(SYNTAX)评分、支架血栓形成状况和死亡率状况。根据院内死亡情况评估死亡率。根据是否存在贫血(PA和HAA)对患者进行分组。

结果

本研究共纳入329例患者。其中,非贫血组219例(66.56%),PA组58例(17.63%),HAA组52例(15.81%)。所有参与者的平均年龄为61.27±12.45岁,其中76.29%为男性。14例(4.26%)患者在住院期间死亡。多变量逻辑回归分析显示,既往冠状动脉疾病(OR:3.779,95%CI:1.141-12.508,P=0.030)、PA(OR:7.043,95%CI:1.574-31.517,P=0.011)、HAA(OR:5.857,95%CI:1.260-27.23,6,P=0.024)和高白细胞计数(OR:1.190,95%CI:1.028-1.378,P=0.020)与院内死亡风险增加独立相关。

结论

因此,有冠状动脉疾病史、PA、HAA和高白细胞计数的患者院内死亡风险较高,应对这些患者采取额外的预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b1c/11681774/f107655e35d7/IJGM-17-6431-g0001.jpg

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