Hemoglobine Level as Predictor of Inhospital Mortality in ACS Patients SCIENCE Registry Sub-Study

Author : A. R. Gemilang, H. Purnasidha, N. Taufiq, B. Y. Setianto
Upload Date : 19-04-2018

Background: Hemoglobine Levels was one of important comorbidities of ACS patients. Anemia has been associated with poor prognosis in ACS patients despite  being  reperfused.  Several hypothesis has been proposed, like potentiation blood supply and demand imbalance, impaired capacity of vascular healing and increasing oxygen consumption. The need of studies reinforcing high prevalence and substantial risk of anemia in ACS patients was increasing recently.

Aim :  Estimate effect of low hemoglobine level in predicting inhospital mortality in our patients

Method : This prospective cohort study was performed as a substudy on the SCIENCE (Sardjito Cardiovascular Intensive Care) ACS registry from January 2017 until October 2017. Patients that met inclusion criterias (diagnosed as ACS, got routine blood exam checked at admission) classified to two categories based on  hemoglobine levels (according to WHO Criteria of Anemia): anemia (Hb <13 g/dL for men and Hb <12 g /dL for women) and not anemia ( Hb >13 g/dL for men and Hb  >12 g /dL for women). We compare proportion of inhospital mortality in each groups using ChiSquare model.

Result : Total of 543 patients diagnosed as ACS , whether STEACS or NSTEACS included in our study. Based on WHO Criteria, as many as 180 patients (33,1 %) included in anemia group whether 363 patients (66,9%) were in non anemia group. Baseline characteristic in both group showed us no significant differences, except STEACS patient proportion (p 0,042), age (p <0,001), occurrence of arrhythmia (p 0,01) , male sex (p 0,002)and length of stay (p<0,01). Rate of inhospital mortality in anemia group reached 25 from 180 patients (13,9%) higher than non anemia group (28 from 363 patients, 7,7%).The Relative Risk(RR) was 1,8 with p value 0,022 (95% CI), considered statistically significant.


Conclusion : Low Hemoglobine level was associated with higher inhospital mortality in ACS patients. Limitation of this study was relatively small sample and selection bias

KEYWORDS : Hemoglobin level, Anemia, WHO Criteria, Acute Coronary Syndrome, Inhospital Mortality

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