European Heart Journal Advance Access originally published online on March 15, 2007
European Heart Journal 2007 28(11):1289-1296; doi:10.1093/eurheartj/ehm013
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Changes in haemoglobin levels during hospital course and long-term outcome after acute myocardial infarction
Department of Cardiology, Rambam Medical Center, Rappaport Family Faculty of Medicine, Technion, PO Box 9602, Haifa 31096, Israel
Received 14 August 2006; revised 5 February 2007; accepted 15 February 2007; online publish-ahead-of-print 15 March 2007.
* Corresponding author. Tel: +972-48-542790; fax: +972-48-542176. E-mail address: daronson{at}techunix.technion.ac.il
See page 1273 for the editorial comment on this article (doi:10.1093/eurheartj/ehm132)
Aims: To study the prevalence and long-term prognostic significance of changes in haemoglobin levels during hospital course in survivors of acute myocardial infarction (AMI).
Methods and results: A prospective study involving 1390 patients who were admitted with AMI. Median follow-up was 24 months. Multivariable Cox models were used to evaluate the relationship between nadir and discharge haemoglobin and mortality after hospital discharge. Anaemia was present in 248 patients on admission (17.8%) and in 502 patients at discharge (36.1%). Nadir haemoglobin during hospital course was 1.3 g/dL lower (IQR 0.6–2.2) when compared with baseline haemoglobin (P < 0.0001). Low nadir haemoglobin and discharge haemoglobin were strongly associated with increased mortality. After adjusting for clinical variables and ejection fraction, the hazard ratios for a 1 g/dL decrease in nadir haemoglobin and discharge haemoglobin were 1.36 (95% CI 1.19–1.55; P < 0.0001) and 1.27 (95% CI 1.16–1.40; P < 0.0001), respectively.
Conclusion: The development of anaemia during hospitalization for AMI is frequent and is associated with an increased long-term mortality.
Key Words: Anaemia • Heart failure • Myocardial infarction • Prognosis
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