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Title:

Prognostic value of haemoglobin drop in patients with acute coronary syndromes.

Document type:
Article; Journal Article; Observational Study
Author(s):
Ndrepepa, Gjin; Neumann, Franz-Josef; Menichelli, Maurizio; Holdenrieder, Stefan; Richardt, Gert; Mayer, Katharina; Cassese, Salvatore; Xhepa, Erion; Kufner, Sebastian; Wiebe, Jens; Joner, Michael; Kessler, Thorsten; Laugwitz, Karl Ludwig; Schunkert, Heribert; Kastrati, Adnan
Abstract:
BACKGROUND: The prognostic value of in-hospital haemoglobin drop in patients with acute coronary syndrome (ACS) undergoing invasive therapy remains insufficiently investigated. MATERIALS AND METHODS: This observational study included 3838 patients with ACS with admission and in-hospital nadir haemoglobin values available. Haemoglobin drop was defined as a positive difference between admission and nadir haemoglobin values. The primary endpoint was one-year all-cause mortality. RESULTS: In-hospital haemoglobin drop occurred in 3142 patients (82%). Patients were categorized into 4 groups: no haemoglobin drop (n = 696 patients), <3 g/dl haemoglobin drop (n = 2703 patients), 3 to <5 g/dl haemoglobin drop (n = 344 patients) and ≥5 g/dl haemoglobin drop (n = 95 patients). The primary endpoint occurred in 156 patients: 17 patients (2.5%) in the group with no haemoglobin drop, 81 patients (3.0%) in the group with <3g/dl haemoglobin drop, 37 patients (10.9%) in the group with 3 to <5 g/dl haemoglobin drop and 21 patients (22.2%) in the group with ≥5 g/dl haemoglobin (adjusted hazard ratio [HR] = 1.30, 95% confidence interval 1.17 to 1.45; p < .001 for one g/dl haemoglobin drop). The association of haemoglobin drop with one-year mortality remained significant after exclusion of patients with in-hospital overt bleeding (adjusted HR = 1.27 [1.11-1.46]; p < .001 for one g/dl haemoglobin drop). The lowest haemoglobin drop associated with mortality was 1.23 g/dl in all patients (HR = 1.03 [1.02-1.04]) and 1.13 g/dl in patients without overt bleeding (HR = 1.03 [1.01-1.04]). CONCLUSIONS: In patients with ACS, in-hospital haemoglobin drop was associated with higher risk of one-year mortality even in the absence of overt bleeding.
Journal title abbreviation:
Eur J Clin Invest
Year:
2021
Journal volume:
51
Journal issue:
12
Fulltext / DOI:
doi:10.1111/eci.13670
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/34541662
Print-ISSN:
0014-2972
TUM Institution:
Institut für Laboratoriumsmedizin (keine SAP-Zuordnung!); Klinik und Poliklinik für Innere Medizin I, Kardiologie
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