Six-month mortality and cardiac catheterization in non-ST-segment elevation myocardial infarction patients with anemia
Authors
Wu, Wen-ChihWaring, Molly E.
Lessard, Darleen M.
Yarzebski, Jorge L.
Gore, Joel M.
Goldberg, Robert J.
UMass Chan Affiliations
Meyers Primary Care InstituteDepartment of Quantitative Health Sciences
Department of Medicine, Division of Cardiovascular Medicine
Document Type
Journal ArticlePublication Date
2011-08-01Keywords
AgedAged, 80 and over
Anemia
Electrocardiography
Heart Catheterization
Hematocrit
Hospitalization
Humans
Massachusetts
Middle Aged
Myocardial Infarction
Retrospective Studies
UMCCTS funding
Cardiovascular Diseases
Health Services Research
Metadata
Show full item recordAbstract
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.Source
Coron Artery Dis. 2011 Aug;22(5):317-23. doi 10.1097/MCA.0b013e3283471fb1.
DOI
10.1097/MCA.0b013e3283471fb1Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50291PubMed ID
21738102Related Resources
ae974a485f413a2113503eed53cd6c53
10.1097/MCA.0b013e3283471fb1