Coronary Artery DiseasePrognostic Impact of Age and Hemoglobin in Acute ST-Segment Elevation Myocardial Infarction Treated With Reperfusion Therapy
Section snippets
Methods
Our data come from the DIAMANTE (Descripción del Infarto Agudo de Miocardio: Actuaciones, Novedades, Terapias y Evolución—Description of Acute Myocardial Infarction: Management, New Therapies and Evolution) registry.14, 15 This database includes prospectively collected consecutive patients with STEMI admitted to the Coronary Intensive Care Unit of the Gregorio Marañón University Hospital (Madrid, Spain), a primary percutaneous coronary intervention (PCI)–capable tertiary center offering service
Results
A total of 1,111 patients were included; 1,032 (92.9%) received primary angioplasty (including 41 patients with rescue PCI) and 79 thrombolytic therapy [7.1%] without rescue PCI. The mean age was 64.1 ± 14.0 years, and 258 were women (23.2%). The proportion of women and the prevalence of risk factors increased with age, except in the case of tobacco consumption where the opposite was seen (Table 1). Age was also associated with lower hemoglobin level at admission and a higher rate of hospital
Discussion
Our study confirms the higher risk profile of older patients with STEMI. Our main finding is the association of hemoglobin with prognosis, also present in patients with normal hemoglobin levels, particularly in older patients. This is important as hemoglobin levels decrease with age.21
In DIAMANTE at hospital admission, 15% of all patients had anemia. Anemia has been reported to be present in 15% to 30% of patients with acute myocardial infarction,10, 22 but this rate can go as high as 43% in
Disclosures
The authors have no conflicts of interest to disclose.
References (30)
- et al.
What to expect from the evolving field of geriatric cardiology
J Am Coll Cardiol
(2015) - et al.
Prognosis of elderly patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention in 2001 to 2011: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) registry
Am Heart J
(2014) - et al.
Acute myocardial infarction in the elderly: differences by age
J Am Coll Cardiol
(2001) - et al.
Chronic ischaemic heart disease in the elderly
Med Clin (Barc)
(2016) - et al.
How should age affect management of acute myocardial infarction? A prospective cohort study
Lancet
(1999) - et al.
Influence of age on gender differences in the management of acute inferior or posterior myocardial infarction
Chest
(2005) - et al.
Very low risk ST-segment elevation myocardial infarction? It exists and may be easily identified
Int J Cardiol
(2017) - et al.
Sex differences in acute myocardial infarction: is it only the age?
Int J Cardiol
(2017) - et al.
Chronic kidney disease
Lancet
(2012) - et al.
Hemoglobin concentration is an independent determinant of heart failure in acute coronary syndromes: cohort analysis of 2310 patients
Am Heart J
(2006)
Impact of anemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy (from the HORIZONS-AMI trial)
Am J Cardiol
Usefulness of anemia in men as an independent predictor of two-year cardiovascular outcome in patients presenting with acute coronary syndrome
Am J Cardiol
Age-related increase in mortality among patients with acute myocardial infarction treated with thrombolysis
N Engl J Med
Long-term ischaemic and bleeding outcomes after primary percutaneous coronary intervention for ST-elevation myocardial infarction in the elderly
Neth Heart J
Adherence to national guidelines for drug treatment of suspected acute myocardial infarction: evidence for undertreatment in women and the elderly
Arch Intern Med
Cited by (0)
See page 1915 for disclosure information.