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Anemia increases a patient's risk of dying after hospitalization for unstable angina or heart attack

Patients hospitalized for acute coronary syndrome (ACS), that is, unstable angina or heart attack, who are discharged with moderate to severe anemia, have a 2.5 times greater risk of dying within 2 years after discharge, according to a study supported by the Agency for Healthcare Research and Quality (HS11282). Researchers assessed the survival rate of 1,038 patients admitted to the hospital for ACS. They classified their discharge hematocrit values as normal (higher than 39 percent), mildly anemic (33.1 to 39 percent), and moderately/severely anemic (33 percent or lower).

Worsening anemia was associated with a decreased 2-year survival rate (normal, 95.8 percent; mild anemia, 91.2 percent; moderate/severe anemia, 81.5 percent). After adjusting for other factors affecting survival, patients discharged with moderate/severe anemia were more than twice as likely to die within 2 years.

Women and those with coexisting illnesses tended to be more anemic at discharge. Also, moderate/severe anemia at discharge was more common in patients who had suffered heart attacks than it was in patients who had unstable angina (63.7 vs. 36.3 percent). Additional factors significantly associated with mortality included older age, diabetes, chronic lung disease, previous heart attack, and cardiac ejection fraction less than 40 percent (indicating a weakened heart muscle).

See "Relation of anemia at discharge to survival after acute coronary syndromes," by Joseph Vaglio, M.D., M.B.A., David M. Safley, M.D., Mohamed Rahman, M.D., and others, in the American Journal of Cardiology 96, pp. 496-499, 2005.

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