Abstract 18622: Impact of Chronic Kidney Disease and Anemia on 5-Year Mortality After Acute Myocardial Infarction
Background: Several studies have shown that both chronic kidney disease (CKD) and anemia are risk factors for mortality in patients with acute myocardial infarction (AMI).
Method: This study was undertaken to investigate prognostic utility of combination of CKD and anemia in AMI. Between January 1996 and December 2005, 878 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. Creatinine and hemoglobin were measured on admission in these patients. CKD was defined estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m2 of body-surface area (stage 3-5). Anemia was defined using World Health Organization criteria (hemoglobin level <13 g/dL for men and <12 g/dL for women).
Results: Both CKD (81% v.s. 94%, p<0.0001) and anemia (82% v.s. 90%, p=0.006) were associated with lower 5-year survival rate. In patients without CKD, anemia was associated with lower 5-year survival rate (90% v.s. 95%, p=0.03) (Figure 1), but not in patients with CKD (79% v.s. 83%, p=0.46). Multivariate analysis showed that hemoglobin level on admission was an independent predictor for 5-year survival in patients without CKD (OR 1.34, 95%CI 1.06-1.70, p=0.02), but not in patients with CKD (OR 0.92, 95%CI 0.76-1.12, p=0.40).
Conclusion: In patients without CKD, admission hemoglobin level was an independent predictor for death after AMI. However, in patients with CKD, prognosis after AMI was poor regardless of presence of anemia.
- © 2013 by American Heart Association, Inc.