PMID- 17161058
OWN - NLM
STAT- MEDLINE
DCOM- 20070108
LR  - 20061212
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 152
IP  - 6
DP  - 2006 Dec
TI  - Hemoglobin concentration is an independent determinant of heart failure in acute 
      coronary syndromes: cohort analysis of 2310 patients.
PG  - 1091-5
AB  - BACKGROUND: Anemia is an important determinant of heart failure and death after 
      ST elevation myocardial infarction (STEMI). The frequency of anemia and its 
      impact on these outcomes across the range of acute coronary syndromes (ACS), 
      however, have not been defined. METHODS: This is a cohort study of 2310 patients 
      with ACS stratified by quartiles of admission hemoglobin concentration [Hb]): Q1, 
      <12.5 g/dL; Q2, 12.5-13.6 g/dL; Q3, 13.7-14.7 g/dL; Q4, >14.7 g/dL. RESULTS: 
      There were 29.7% of women and 23.2% of men who were anemic. Rates of STEMI 
      increased across [Hb] quartile groups from 25.0% (Q1) to 35.5% (Q4) as rates of 
      unstable angina decreased from 52.0% (Q1) to 40.7% (Q4) (P < .0005). Despite 
      this, rates of left ventricular failure (LVF) were inversely related to [Hb] in 
      all diagnostic groups, patients with unstable angina (Q1, 14.2%; Q4, 4.4%; P < 
      .0005) showing a similar trend to patients with non-STEMI (Q1, 26.8%; Q4, 10.4%; 
      P < .0005) and STEMI (Q1, 33.8%; Q4, 20.6%; P < .0005). The age-adjusted odds of 
      LVF in Q4 compared with Q1 were 0.64 (95% confidence interval, 0.45-0.90). 
      Inhospital cardiac mortality was 3.0% and was not influenced by [Hb]. 
      CONCLUSIONS: Anemia is a common comorbidity in patients presenting with ACS, and 
      it is a powerful independent determinant of LVF. The association with LVF occurs 
      not only in STEMI but also in less severe diagnostic groups.
FAU - Archbold, R Andrew
AU  - Archbold RA
AD  - Department of Cardiology, Newham University Hospital, London, United Kingdom. 
      andrew.archbold@bartsandthelondon.nhs.uk
FAU - Balami, Dauda
AU  - Balami D
FAU - Al-Hajiri, Abdul
AU  - Al-Hajiri A
FAU - Suliman, Abdel
AU  - Suliman A
FAU - Liew, Reg
AU  - Liew R
FAU - Cooper, Jackie
AU  - Cooper J
FAU - Ranjadayalan, Kulasegarum
AU  - Ranjadayalan K
FAU - Knight, Charles J
AU  - Knight CJ
FAU - Deaner, Andrew
AU  - Deaner A
FAU - Timmis, Adam D
AU  - Timmis AD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Aged, 80 and over
MH  - Anemia/complications
MH  - Angina, Unstable/blood/complications
MH  - Cardiac Output, Low/*etiology
MH  - Cardiovascular Diseases/*blood/*complications/mortality
MH  - Cohort Studies
MH  - Electrocardiography
MH  - Female
MH  - Hemoglobins/*metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/blood/complications/diagnosis
MH  - Osmolar Concentration
MH  - Prospective Studies
MH  - Syndrome
MH  - Ventricular Dysfunction, Left/etiology
EDAT- 2006/12/13 09:00
MHDA- 2007/01/09 09:00
CRDT- 2006/12/13 09:00
PHST- 2006/02/14 00:00 [received]
PHST- 2006/07/27 00:00 [accepted]
PHST- 2006/12/13 09:00 [pubmed]
PHST- 2007/01/09 09:00 [medline]
PHST- 2006/12/13 09:00 [entrez]
AID - S0002-8703(06)00671-5 [pii]
AID - 10.1016/j.ahj.2006.07.020 [doi]
PST - ppublish
SO  - Am Heart J. 2006 Dec;152(6):1091-5. doi: 10.1016/j.ahj.2006.07.020.