Nesrine Amdouni1, Ikram Chamtouri1, Asma Ben Abdallah1, Walid Jomaa1, Khaldoun Ben Hamda1, Faouzi Maatouk1
1CHU FAttouma Bourguiba Monastir, Monastir, Tunisia
Anemia is becoming a common comorbidity factor among patients with STEMI. The aim of this study was to analyse the prevalence and the impact of anemia on prognosis and mortality in these patients.
We retrospectively included 352 patients with STEMI, who were enrolled between January 2000 and March 2017 in cardiology B deparment of Fattouma Bourguiba Hospital. According to the World Health Organization, anemia was defined as serum hemoglobin level < 13g/dl for men and < 12g/dl for women. It was devided into mild, moderate, and severe anemia. Anemic patients were compared with no-anemic patients for clinical, prognosis and mortality features.
A total of 352 patients were included in the analysis. Mean age was 60 ± 11.56 years with marked male predominance (84%). Anemia was present in 133 patients (37.8%) of whom 108 had mild anemia, 16 moderate anemia, and 8 severe anemia. Anemic patients were significantly older (p=0.042) and had higher prevalence of comorbidities including hypertension, diabetes mellitus, cerebrovascular diseases than no-anemic patients. Lower hemoglobin levels were significantly associated to higher prevalence of cardiogenic chock (p=0.021), severe ventricular arythmia (p=0.014). Moderate to severe anemia was related with a higher in-hospital mortality (p=0.006) compared to mild and no-anemic patients. Its associated factors were smoking (p=0.038), diabetes mellitus (p=0.042), renal failure (p<0.001), and heart failure on admission (p<0.001).
Presence and severity of anemia is an important predictor of higher in-hospital mortality in patients with STEMI. Unfortunately, treatment of anemia in cardiovascular disease lacks clear targets and specific therapy is not defined.