Anaemia to predict outcome in patients with acute coronary syndromes
| Autor: | Sylvestre Maréchaux, Jonathan Finzi, Nadia Bouabdallaoui, Stéphanie Barrailler, Eric Van Belle, Claire Pinçon, Jean-Philippe Collet, Pierre Vladimir Ennezat, Gilles Montalescot |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Time Factors GRACE score Myocardial Infarction Anaemia Comorbidity Kaplan-Meier Estimate Acute coronary syndromes Lower risk Patient Readmission Risk Assessment Disease-Free Survival Tertiary Care Centers Coronary artery disease Hemoglobins Risk Factors Internal medicine medicine Clinical endpoint Health Status Indicators Humans Prospective Studies Registries Myocardial infarction Acute Coronary Syndrome Aged Proportional Hazards Models Chi-Square Distribution Framingham Risk Score business.industry Hazard ratio Anemia General Medicine Middle Aged Syndrome coronaire aigu medicine.disease Anémie Confidence interval Surgery Score GRACE Multivariate Analysis Female France business Cardiology and Cardiovascular Medicine Biomarkers |
| Zdroj: | Archives of Cardiovascular Diseases. 106(6-7):357-365 |
| ISSN: | 1875-2136 |
| DOI: | 10.1016/j.acvd.2013.04.004 |
| Popis: | SummaryBackgroundOwing to the heterogeneous population of patients with acute coronary syndromes (ACS), risk stratification with tools such as the GRACE risk score is recommended to guide therapeutic management and improve outcome.AimTo evaluate whether anaemia refines the value of the GRACE risk model to predict midterm outcome after an ACS.MethodsA prospective registry of 1064 ACS patients (63±14years; 73% men; 57% ST-segment elevation myocardial infarction [MI]) was studied. Anaemia was defined as haemoglobin less than 13mg/dL in men or less than 12mg/dL in women. The primary endpoint was 6-month death or rehospitalization for MI.ResultsThe primary endpoint was reached in 132 patients, including 68 deaths. Anaemia was associated with adverse clinical outcomes (hazard ratio 3.008, 95% confidence interval 2.137–4.234; P5–10%) or high risk (>10%); 79.5% patients at intermediate risk were reclassified as low (55%) or high risk (24%); and 45.5% patients at high risk were downgraded to intermediate risk. Overall, 174 patients were reclassified into a higher risk category (17.3%) and 421 into a lower risk category (41.9%).ConclusionAnaemia provides independent additional prognostic information to the GRACE score. Combining anaemia with the GRACE score refines its predictive value, which often overestimates the risk. |
| Databáze: | OpenAIRE |
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