ANEMIA OF VARYING SEVIRITY DEGREES IN PATIENTS WITH STEMI

Abstract. Introduction. Anemia associated with cardiovascular diseases, particularly with myocardial infarction, is a significant risk factor for adverse outcomes. At the same time, it is poorly known about the issue of acute blood circulatory disturbances during myocardial infarction in the setting of anemia of varying severity degrees. Our aim was to study the at-admission hemoglobin levels in patients with ST-elevation myocardial infarction with favorable and fatal outcomes of hospitalization. Material and Methods. We selected 177 records of patients with fatal outcomes of and 380 records of patients discharged with favorable outcomes of ST-elevation myocardial infarction from the emergency departments for patients with acute coronary syndrome of State Clinical Hospital 7, Kazan. The study included 349 men and 208 women aged 32 to 96 years, median age being 67 (58–76) years. Results and Discussion. Incidence of anemia (hemoglobin lower than 130 g/l in men and 110 g/l in women) in the group of patients under study with favorable and fatal hospitalization outcomes was significantly different and amounted to 8.7% and 18.1%, respectively (p = 0.001). Probability of unfavorable outcomes in the group of patients with anemia was 2.32 times higher than that in the group of patients without anemia, the differences in odds were statistically significant (95% CI: 1.38 - 3.92; p = 0.001). Moderate and severe anemia (Hb <90 g/l) was more common in patients with unfavorable outcomes than in patients with favorable outcomes of hospitalization, i.e., in 43.8% and 15.2% of cases, respectively. Odds of an unfavorable outcome were 4.35 times higher in patients with moderate to severe anemia than in patients with mild anemia, the difference in odds was statistically significant (95% CI: 1.34 - 14.08, p = 0.015). Conclusions. Anemia in an ST-elevation myocardial infarction patient is associated with a 2.32 greater chance of an unfavorable outcome. A decrease in hemoglobin level below 90 g/L in a patient with ST-elevation myocardial infarction is associated with a 4.35 times greater chance of an unfavorable outcome.