Document Detail


Six-month mortality and cardiac catheterization in non-ST-segment elevation myocardial infarction patients with anemia.
MedLine Citation:
PMID:  21738102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is unknown how anemia influences the invasive management of patients with non-ST-segment elevation myocardial infarction (NSTEMI) and associated mortality. We investigated whether receipt of cardiac catheterization relates to 6-month death rates among patients with different severity of anemia.
METHODS: We used data from the population-based Worcester Heart Attack Study, which included 2634 patients hospitalized with confirmed NSTEMI, from three percutaneous coronary intervention-capable medical centers in the Worcester (Massachusetts, U.S.A.) metropolitan area, during five biennial periods between 1997 and 2005. Severity of anemia was categorized using admission hematocrit levels: less than or equal to 30.0% (moderate-to-severe anemia), 30.1-39.0% (mild anemia), and more than 39.0% (no anemia). Propensity matching and conditional logistic regression adjusting for hospital use of aspirin, heparin, and plavix compared 6-month postadmission all-cause mortality rates in relation to cardiac catheterization during NSTEMI hospitalization.
RESULTS: Compared with patients without anemia, patients with anemia were less likely to undergo cardiac catheterization {adjusted odds ratio (AOR) 0.79 [95% confidence interval (CI): 0.67-0.95] for mild anemia and 0.45 (95% CI: 0.42-0.49) for moderate-to-severe anemia}. After propensity matching, cardiac catheterization was associated with lower 6-month death rates only in patients without anemia [AOR 0.26 (95% CI: 0.09-0.79)] but not in patients with mild anemia [AOR 0.55 (95% CI: 0.25-1.23)]. The small number of patients rendered data inconclusive for patients with moderate-to-severe anemia.
CONCLUSION: Anemia at the time of hospitalization for NSTEMI was associated with lower utilization of cardiac catheterization. However, cardiac catheterization use was associated with a decreased risk of dying at 6 months after hospital admission only in patients without anemia.
Authors:
Wen-Chih Wu; Molly E Waring; Darleen Lessard; Jorge Yarzebski; Joel Gore; Robert J Goldberg
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Coronary artery disease     Volume:  22     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-08     Completed Date:  2011-11-08     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  317-23     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anemia / mortality*
Cardiac Catheterization / mortality*
Electrocardiography
Hematocrit
Hospitalization
Humans
Massachusetts
Middle Aged
Myocardial Infarction / mortality*,  therapy
Retrospective Studies
Grant Support
ID/Acronym/Agency:
1U01 HL105268-01/HL/NHLBI NIH HHS; R01 HL035434/HL/NHLBI NIH HHS; R01 HL035434-27/HL/NHLBI NIH HHS; R01 HL35434/HL/NHLBI NIH HHS; UL1 RR031982/RR/NCRR NIH HHS; UL1 RR031982-02/RR/NCRR NIH HHS
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