Prognostic value of haemoglobin drop in patients with acute coronary syndromes. (20th September 2021)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: European journal of clinical investigation. Volume 51:Number 12(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-09-20
• Subjects: acute coronary syndrome -- bleeding -- haemoglobin -- mortality; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.13670
• Languages: English
• ISSNs: 0014-2972

Abstract

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.