Abstract 13347: Effect of Severe Anemia (hemoglobin < 10g/dl) on Short- and Long-term Outcome in Acute Coronary Syndrome: Insights of a Terciary Centre

Abstract

Introduction: Although invasive strategies are the generalized approach in the management of ACS pts, their benefits in pts with significant anemia are unclear, as anemia is strongly associated with increased risk of morbidity and mortality. Aim: To determine the incidence and the impact of severe anemia (hemoglobin<10g/dL) on short- and long-term outcome in pts hospitalized with ACS. Methods: We analyzed retrospectively 2905 ACSpts admitted for 6 years in our CCU. Pts were divided into two groups: group 1-pts with severe anemia(hemoglobin < 10g/dL) (n=257,8.8%); group 2-pts without severe anemia (hemoglobin >=10g/dL) (n=2648,91.2%). Primary endpoint was the occurrence of a composite of death and adverse cardiovascular events (stroke, reinfarction, and rehospitalization of cardiovascular etiology) at 6 months; FU was completed in 96%pts. Results: The sample consisted in 77.9% men and 22.1% women, with mean age of 64±13 years. The incidence of severe anemia was 8.8%. Group1 pts were older (p<0.001), had a higher proportion of women (p<0.001), diabetes (p<0.001), CKD (p<0.001) and AF (p<0.001). During hospitalization, group 1 had more HF (p<0.001), angor (p<0.001), refarction (p=0.006), bleeding (p<0.001) and transfusion (p<0.001). Group 1 had a higher proportion of NSTEMI (p=0.009) as opposed to group2 which had more STEMI (p=0.031). During hospitalization, group 2 pts were more likely to undergo revascularization (p<0.001). A multivariate analysis identified age [OR 1.06, 95%CI 1.04 to 1.07; p<0.001] and feminine sex [OR 2.61, 95%CI 1.89 to 3.61; p<0.001] as independent predictors of severe anemia during hospitalization. Pts with severe anemia had higher 6-month mortality (32.1%vs6.9%;p<0.001). In multivariate analysis and after adjusting for different baseline characteristics, pts with severe anemia had higher occurrence of a composite of death and MACE at 6months [OR5.04,95%CI 1.21 to 21.04;p=0.026]. Conclusion: Severe anemia was strongly associated with increased risk of morbidity and mortality in ACS pts. However, pts with severe anemia who were double antiaggregated had no worse outcomes than those who had simple antiaggregation after 6months. Therefore, there was no significant difference regarding revascularization in these pts.