Anaemia in acute coronary syndrome: a cross-sectional study

Muhammad Dilawaer Khan; Jahan Tab Qazi; Hamza Maqsood; Shaheryar Qazi; Khurram Irshad; Hassan Abdullah Shakeel

doi:10.18203/2320-6012.ijrms20193370

Authors

Muhammad Dilawaer Khan Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan
Jahan Tab Qazi Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan
Hamza Maqsood Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan
Shaheryar Qazi Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan
Khurram Irshad Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan
Hassan Abdullah Shakeel Department of Medicine, Nishtar Medical University, Multan, Punjab, Pakistan

DOI:

https://doi.org/10.18203/2320-6012.ijrms20193370

Keywords:

Non ST elevation myocardial infarction, Non-vegetarian, ST elevation myocardial infarction, Unstable angina.

Abstract

Background: Acute coronary syndromes (ACS) are an imbalance between myocardial oxygen supply and demand, and the presence of anaemia further potentiates this imbalance. The burden of anaemia in patients presenting with acute coronary syndromes (ACS) is significant. Anaemia has the potential to worsen myocardial ischemic insult by decreasing the oxygen content of the blood supplied to the jeopardized myocardium. Present study investigates the prevalence of anaemia in ACS patients attending a tertiary health care institute.

Methods: A total of 148 patients with ACS were recruited in the study from July 2018 to October 2018 in Multan institute of cardiology, Pakistan. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent. Patient having any other diseases known to cause anaemia were excluded.

Results: Mean age of patients was 49 years. Out of 148, 114 (77%) were males and 34(23%) were females. Prevalence of anaemia was 38% in Male and 58.8% in Female. Among Male, 18.8% were microcytic, 4.54% were macrocytic and 77.27% were normocytic. Among Female, 50% were microcytic and 50%% were normocytic. Prevalence of ACS was higher is patients with diabetes and hypertension combined (31%) than in patient with diabetes alone (17.56%) or hypertension alone (21.62%). 13.51% were pure vegetarians while 78.37% were on mixed diet consisting of vegetables+meat+pulses.

Conclusions: Higher incidence of anaemia was reported in subjects having acute coronary syndrome. Incidence of anaemia in STEMI patients was greater than NSTEMI and unstable angina patients. Severe form of acute coronary syndrome i.e. STEMI was associated with higher incidence of anaemia.

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References

Aronson D, Suleiman M, Agmon Y, Suleiman A, Blich M, Kapeliovich M, et al. Changes in haemoglobin levels during hospital course and long term outcome after acute myocardial infarction. Eur Heart J. 2007 Mar 15;28(11):1289-96.

Giraldez RR, Sabatine MS, Morrow DA, Mohanavelu S, McCabe CH, Antman EM, et al. Baseline hemoglobin concentration and creatinine clearance composite laboratory index improves risk stratification in ST-elevation myocardial infarction. Am Heart J. 2009 Mar 1;157(3):517-24.

Al Falluji N, Lawrence-Nelson J, Kostis JB, Lacy CR, Ranjan R, Wilson AC. Effect of anaemia on 1year mortality in patients with acute myocardial infarction. Am Heart J. 2002Oct1;144(4):636-41.

Alexander KP, Chen AY, Wang TY, Rao SV, Newby LK, LaPointe NM, et al. Transfusion practice and outcomes in non-ST-segment elevation acute coronary syndromes. Am Heart J. 2008 Jun 1;155(6):1047-53.

Anker SD, Voors A, Okonko D, Clark AL, James MK, von Haehling S, et al. Prevalence, incidence, and prognostic value of anaemia in patients after an acute myocardial infarction: data from the OPTIMAAL trial. Eur Heart J. 2009 Apr 21;30(11):1331-9.

Kunadian V, Mehran R, Lincoff AM, Feit F, Manoukian SV, Hamon M, et al. Effect of anaemia on frequency of short- and long-term clinical events in acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial). Am J Cardiol. 2014 Dec 15;114(12):1823-9.

Tsujita K, Nikolsky E, Lansky AJ, Dangas G, Fahy M, Brodie Br, et al. Impact of anaemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy. Am J Cardiol. 2010 May 15;105(10):1385-94.

Riley RF, Newby LK, Don CW, Alexander KP, Peterson ED, Peng SA, et al. Guidelines-based treatment of anaemic STEMI patients: practice patterns and effects on in-hospital mortality: a retrospective analysis from the NCDR. Eur Heart J Acute Cardiovasc Care. 2013;2(1):35-43.

Most AS, Ruocco NA Jr, Gewirtz H. Effect of a reduction in blood viscosity on maximal myocardial oxygen delivery distal to a moderate coronary stenosis. Circulation. 1986 Nov;74(5):1085-92.

Levy PS, Quigley RL, Gould SA. Acute dilutional anaemia and critical left anterior descending coronary artery stenosis impairs end organ oxygen delivery. J Trauma. 1996 Sep 1;41(3):416-23.

Archbold RA, Balami D, Al-Hajiri A, Suliman A, Liew R, Cooper J, et al. Hemoglobin concentration is an independent determinant of heart failure in acute coronary syndromes: cohort analysis of 2310 patients. Am Heart J. 2006 Dec 1;152(6):1091-5.

Sudarsky D, Sudarsky M, Matezky S, Goldenberg I, Farcas A, Nikolsky E. Impact of early invasive approach on outcomes of patients with acute coronary syndrome and baseline anaemia: analysis from ACSIS registry. J Interv Cardiol. 2015 Aug;28(4):315-25.

Kruk M, Przyluski J, Kalinczuk L, Pregowski J, Kadziela J, Kaczmarska E, et al. Hemoglobin, leukocytosis and clinical outcomes of ST elevation myocardial infarction treated with primary angioplasty: ANIN Myocardial Infarction Registry. Circ J. 2009;73(2):323-9.

Lawler PR, Filion KB, Dourian T, Atallah R, Garfinkle M, Eisenberg MJ. Anaemia and mortality in acute coronary syndromes: a systematic review and metaanalysis. Am Heart J. 2013 Feb 1;165(2):143-53.

Greenberg G, Assali A, Vaknin-Assa H, Brosh D, Teplitsky I, Fuches S, et al. Hematocrit level as a marker of outcome in ST-segment elevation myocardial infarction. Am J Cardiol. 2010 Feb 15;105(4):435-40.

Valeur N, Nielsen OW, McMurray JJ, TorpPedersen C, Kober L. Anaemia is an independent predictor of mortality in patients with left ventricular systolic dysfunction following acute myocardial infarction. Eur J Heart Fail. 2006 May 5;8(6):577-84.

Sabatine MS, Morrow DA, Giugliano RP, Burton PB, Murphy SA, McCabe CH, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation. 2005 Apr 26;111(16):2042-9.

Nikolsky E, Mehran R, Aymong ED, Mintz GS, Lansky AJ, Lasic Z, et al. Impact of anaemia on outcomes of patients undergoing percutaneous coronary interventions. Am J Cardiol. 2004 Oct 15;94(8):1023-7.

WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.

Gupta SK, Agarwal SS, Kaushal R, Jain A, Gupta VK, Khare N. Prevalence of Anaemia among rural population living in and around of rural health and training center, Ratua Village of Madhya Pradesh. Muller J Med Sci Res. 2014 Jan 1;5(1):15.

Garg P, Deshpande AH, Dey B, Ojha P. A Study of the Peripheral Smears in a Tertiary Care Teaching Hospital of Andaman & Nicobar Islands. Int J Health Sci Res. 2017;7:22-7.

In-hospital Acquired Anemia in Acute Coronary Syndrome. Predictors. In-hospital Prognosis and One-year Mortality. Soc Esp Cardiol. 2012;65(8):742-8.