Abstract 14460: Patterns of Recovery from Acute Hospital-Acquired Anemia After Acute Myocardial Infarction and Association with Clinical Outcomes
Introduction: Acute, hospital-acquired anemia (HAA) that develops during AMI hospitalization is associated with higher long-term mortality and worse health status. Patterns of recovery from HAA and their association with outcomes are unknown.
Methods: In the prospective 24-center TRIUMPH registry of AMI, we identified 530 patients with HAA (defined as normal hemoglobin (Hgb) on admission but anemia at discharge) who also had repeat protocol driven Hgb measurement 1-month post-discharge. We compared 18-month mortality and 12-month health status (Short-Form 12 Physical Component Summary (SF-12 PCS)) of patients with resolved vs. persistent anemia at 1-month with log-rank tests and multivariable Cox proportional hazards regression for mortality analyses and multivariable repeated measures linear regression incorporating 1-, 6- and 12-month SF-12 PCS scores adjusting for baseline scores and clinical variables for health status analyses.
Results: Overall, 365 HAA patients (68.9%) had normal Hgb at 1-month post-discharge while 165 (31.1%) had persistent anemia. Unadjusted mortality was greater in patients with persistent anemia than in those whose anemia resolved (9/160 (4.4)% vs. 8/346 (1.7%), p=0.008)(Figure), however, this association was attenuated after adjustment for GRACE score (HR 1.8 (95% CI 0.7-4.2)). Mean SF-12 PCS scores across time were significantly higher in those with resolved HAA (2.48 (95% CI 0.9-4.0) in comparison to patients with persistent HAA.
Conclusions: HAA persists in one third of AMI patients 1 month post-discharge. Although this study was underpowered for mortality outcomes, patients with persistent HAA had higher unadjusted mortality and significantly worse health status than those with resolved HAA 1-month after discharge. Whether better recognition and management of HAA at the time of discharge can improve patient outcomes remains unknown.
- © 2010 by American Heart Association, Inc.