- © 2012 Marshfield Clinic
Impact of Anemia on In-Hospital, One-Month and One-Year Mortality in Patients with Acute Coronary Syndrome from the Middle East
- Kadhim Sulaiman*⇓,
- Panduranga Prashanth*,
- Ibrahim Al-Zakwani†,
- Wael Al-Mahmeed‡,
- Ahmed Al-Motarreb§,
- Jassim Al Suwaidi¶,
- Haitham Amin||,
- Nidal Asaad¶,
- Ahmad Hersi**,
- Hussam Al Faleh**,
- Shukri Al Saif††,
- Alawi A. Alsheikh-Aliत,
- Jawad Al Lawati¶¶ and
- Khalid Al-Habib**
- *Department of Cardiology, Royal Hospital, Muscat, Oman
- †Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman and Gulf Health Research, Muscat, Oman
- ‡Division of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- §Faculty of Medicine, Sana’s University, Sana’a, Yemen
- ¶Hamad Medical Corporation, Doha, Qatar
- ||Mohammed Bin Khalifa Cardiac Center, Manama, Bahrain
- **King Fahad Cardiac Centre, King Saud University, Riyadh, Kingdom of Saudi Arabia
- ††Saud Al-Babtain Cardiac Centre, Dammam, Saudi Arabia
- §§Tufts Clinical and Translational Science Institute, Tufts University School of Medicine, Boston, Massachusetts, USA
- ¶¶Department of Non-Communicable Diseases Surveillance and Control, Ministry of Health, Muscat, Oman
- Corresponding Author: Dr. Kadhim Sulaiman; Department of Cardiology; Royal Hospital; PO Box 1331; Muscat PC-111; Sultanate of Oman; Phone: +968-99360025; Fax: +968-24697727; Email: kjsulaiman{at}hotmail.com
Abstract
Aim The aim of this study was to evaluate the impact of admission anemia on in-hospital, one-month, and one-year mortality in patients from the Middle East with acute coronary syndrome (ACS).
Methods Data were analyzed from 7922 consecutive patients admitted to hospitals throughout six Middle-Eastern countries with the final diagnosis of ACS, as part of Gulf RACE II (Registry of Acute Coronary Events II). Anemia at admission was defined according to the World Health Organization definition (<13 g/dL in men and <12 g/dL in women). Analyses were conducted using univariate and multivariate statistical techniques.
Results The median age of the cohort was 56 (48–65) years, with the majority being male (79%). Anemia at admission was present in 2241 patients (28%). Patients with anemia were more likely to have in-hospital complications including heart failure, recurrent ischemia, re-infarction, cardiogenic shock, stroke, and major bleed. Even after adjustment, anemia was still associated with mortality at in-hospital (odds ratio [OR]=1.71, 95% confidence interval [CI], 1.34–2.17; P<0.001), at one-month (OR=1.34, 95% CI, 1.06–1.71; P=0.016), and at one-year (OR=1.22, 95% CI, 1.01–1.49; P=0.049) post-admission with ACS.
Conclusions Admission anemia in patients with ACS from six Middle-Eastern countries was strongly associated with mortality at in-hospital, one-month, and at one-year. Hence, admission anemia must be considered in the initial risk assessment of ACS patients along with other risk scores.
