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Title

Six-month mortality and cardiac catheterization in non-ST-segment elevation myocardial infarction patients with anemia

Authors

Wen-Chih Wu, Brown University
Molly E. Waring, University of Massachusetts Medical SchoolFollow
Darleen M. Lessard, University of Massachusetts Medical SchoolFollow
Jorge L. Yarzebski, University of Massachusetts Medical SchoolFollow
Joel M. Gore, University of Massachusetts Medical SchoolFollow
Robert J. Goldberg, University of Massachusetts Medical SchoolFollow

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine; Department of Quantitative Health Sciences; Meyers Primary Care Institute

Publication Date

2011-8

Document Type

Article

Subjects

Aged; Aged, 80 and over; Anemia; Electrocardiography; Heart Catheterization; Hematocrit; Hospitalization; Humans; Massachusetts; Middle Aged; Myocardial Infarction; Retrospective Studies

Disciplines

Cardiovascular Diseases | Health Services Research

Abstract

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.

Keywords

UMCCTS funding

DOI of Published Version

10.1097/MCA.0b013e3283471fb1

Source

Coron Artery Dis. 2011 Aug;22(5):317-23. doi 10.1097/MCA.0b013e3283471fb1.

Journal/Book/Conference Title

Coronary artery disease

Related Resources

Link to Article in PubMed

PubMed ID

21738102

Repository Citation

Wu, Wen-Chih; Waring, Molly E.; Lessard, Darleen M.; Yarzebski, Jorge L.; Gore, Joel M.; and Goldberg, Robert J., "Six-month mortality and cardiac catheterization in non-ST-segment elevation myocardial infarction patients with anemia" (2011). UMass Center for Clinical and Translational Science Supported Publications. 12.
https://escholarship.umassmed.edu/umccts_pubs/12