基线贫血对非ST段抬高型心肌梗死患者短期和长期预后的影响

I. Bayraktarova, G. Vladimirov, H. Mateev, A. Alexandrov, E. Trendafilova
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引用次数: 0

摘要

入院时贫血是ST段抬高心肌梗死(STEMI)患者死亡的已知预测因素。关于贫血对非ST段抬高型心肌梗死(NSTEMI)患者预后影响的数据不太容易获得。目的:我们旨在评估保加利亚三级中心NSTEMI患者群体中贫血的频率及其对患者即时和长期预后的影响。方法:我们对138名连续的NSTEMI患者进行了前瞻性分析,贫血被定义为女性入院时血红蛋白低于120g/L,男性入院时低于130g/L。结果:贫血患者和非贫血患者的标准危险因素频率没有显著差异。贫血患者往往年龄较大,体重指数较低,肾功能较差。根据肌钙蛋白I的最大值判断,基线贫血患者的GRACE风险评分往往更高,实际心肌梗死的范围更大。两组的介入治疗没有显著差异。贫血患者的中位住院时间明显较长,并发症较多。尽管住院出血没有增加,口服抗聚集剂的治疗也没有差异,但贫血患者接受输血治疗的频率更高。贫血患者在指数住院期间和随访期间的死亡率都较高。结论:NSTEMI患者入院时贫血与院内心血管并发症和出院后全因死亡率的风险增加有关,应将其视为患者总体风险评估中的一个额外风险因素。
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Impact of baseline anemia on the short- and long-term prognosis of patients presenting with non-ST-elevation myocardial infarction
Anaemia at admission is a known predictor of death in patients with myocardial infarction with ST-elevation (STEMI). Data on the effect of anaemia on the prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI) is less readily available. Purpose: We aimed to evaluate the frequency of anaemia in a Bulgarian tertiary centre NSTEMI patient population, and its effect on the immediate and extended prognosis of the patients. Methods: We performed ambispective analysis of 138 consecutive patients with NSTEMI, and anaemia was defi ned as haemoglobin at admission below 120 g/L for females and below 130 g/L for males. Results: There was no signifi cant difference in the frequencies of standard risk factors between patients with and without anaemia. Anaemic patients tended to be older, with lower body mass index and worse kidney function. Patients with baseline anaemia tended to have higher GRACE risk scores and a larger size of the realised myocardial infarction as judged by maximal reached troponin I. There was no signifi cant difference in interventional treatment in both groups. Median hospital stay was signifi cantly longer in anaemic patients and was marked by more complications. Despite a lack of increase in inhospital bleeding and no difference in treatment with oral antiaggregants, patients with anaemia received haemotransfusion treatment more often. Mortality rate was higher in anaemic patients both during the index hospitalization and during the follow up. Conclusion: Anaemia at admission is associated with an increased risk of both in hospital cardiovascular complications and after dehospitalisation all-cause mortality in patients with NSTEMI and should be considered as an additional risk factor in the global risk assessment of patients.
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