Prognostic relevance of normocytic anemia in elderly patients affected by cardiovascular disease  

作　　者：Liana Spazzafumo Fabiola Olivieri Jacopo Sabbatinelli Roberta Galeazzi Rina Recchioni Fiorella Marcheselli Paola Tamburrini Roberto Antonicelli 

机构地区：[1]Epidemiologic Observatory,Regional Health Agency,Regione Marche,Ancona,Italy [2]Department of Clinical and Molecular Sciences,UniversitàPolitecnica delle Marche,Ancona,Italy [3]Center of Clinical Pathology and Innovative Therapy,Italian National Research Centre on Aging,IRCCS INRCA,Ancona,Italy [4]SOD Medicina di Laboratorio,Azienda Ospedaliero Universitaria Ospedali Riuniti,Ancona,Italy [5]Clinical Laboratory and Molecular Diagnostic,Italian National Research Center on Aging,IRCCS INRCA,Ancona,Italy [6]Department of Cardiology-CCU,Italian National Research Centre on Aging,IRCCS INRCA,Ancona,Italy

出　　处：《Journal of Geriatric Cardiology》2021年第8期654-662,共9页老年心脏病学杂志（英文版）

基　　金：supported by grants from Ministero della Salute, Italy (Ricerca Corrente) to IRCCS INRCA;Università Politecnica delle Marche, Ancona, Italy (RSA grant) to Fabiola Olivieri

摘　　要：BACKGROUND Anemia associated with cardiovascular diseases(CVD) is a common condition in older persons. Prevalence and prognostic role of anemia were extensively studied in patients with myocardial infarction(MI) or congestive heart failure(CHF) whereas limited data were available on patients with atrial fibrillation(AF). This study was conducted to assess the clinical prevalence and prognostic relevance of anemia in elderly patients affected by AF and other CVDs.METHODS A total of 866 elderly patients(430 men and 436 women, age: 65-98 years, mean age: 85 ± 10 years) were enrolled.Among these patients, 267 patients had acute non-ST-segment elevation MI(NSTEMI), 176 patients had acute CHF, 194 patients had acute AF and 229 patients were aged-matched healthy persons(CTR). All parameters were measured at the hospital admission and cardiovascular mortality was assessed during twenty-four months of follow-up.RESULTS The prevalence of anemia was higher in NSTEMI, CHF and AF patients compared to CTR subjects(50% vs. 15%, P <0.05), with normocytic anemia being the most prevalent type(90%). Adjusted mortality risk was higher in anemic patient versus non-anemic patient in all the groups of patients [NSTEMI: hazard ratio(HR) = 1.81, 95% CI: 1.06-2.13;CHF: HR = 2.49, 95% CI:1.31-4.75;AF: HR = 1.98, 95% CI: 1.01-3.88]. Decreased hemoglobin levels(P = 0.001) and high reticulocyte index(P = 0.023) were associated with higher mortality in CVD patients.CONCLUSIONS The significant associations between CVD and anemia and the prognostic relevance of anemia for elderly patients with CVD were confirmed in this study. The presence of anemia in AF patients is associated with a two-fold increased mortality risk compared with non-anemic AF patients. Low hemoglobin and high reticulocyte count independently predict mortality in elderly patients with CVD.

关 键 词：PATIENTS ANEMIA CARDIOVASCULAR 

分 类 号：R54[医药卫生—心血管疾病]