TY - JOUR
T1 - Red blood cell indices and development of hospital-acquired anemia during acute myocardial infarction
AU - Salisbury, Adam C.
AU - Amin, Amit P.
AU - Reid, Kimberly J.
AU - Wang, Tracy Y.
AU - Alexander, Karen P.
AU - Chan, Paul S.
AU - Masoudi, Frederick A.
AU - Spertus, John A.
AU - Kosiborod, Mikhail
N1 - Funding Information:
This study was funded by Grant 11GRNT7330005 from the American Heart Association , Dallas, Texas. Dr. Salisbury, Dr. Amin, Dr. Spertus and Dr. Kosiborod are also supported by an Outcomes Research Center Grant from the American Heart Association . Dr. Wang has received research grants from Bristol-Myers Squibb , New York, New York, Daichi , Tokyo, Japan, Heartscape , Bothell, Washington, Eli Lilly , Indianapolis, Indiana, Merck , Whitehouse Station, New Jersey, Sanofi-Aventis , Paris, France, Schering Plough , Whitehouse Station, New Jersey, the Medicines Company , Parsippany, New Jersey, and Canyon Pharmaceuticals , Columbia, Maryland and been a consultant for AstraZeneca, Wilmington, Delaware and Medco, Franklin Lakes, New Jersey. Dr. Masoudi has been on the advisory board of Amgen, Thousand Oaks, California and participated in blinded end-point adjudication for Axio Research, Seattle, Washington. Dr. Spertus has received research grants from the National Heart, Lung, and Blood Institute , Bethesda, Maryland, American College of Cardiology Foundation , Washington, DC, Johnson and Johnson , New Brunswick, New Jersey, Amgen , Thousand Oaks, California, Eli Lilly , Indianapolis, Indiana, Evaheart , Pittsburgh, Pennsylvania, Sanofi Aventis , Paris, France, Roche , Basel, Switzerland, and Atherotech , Birmingham, Alabama and served as a consultant/been on the advisory board for St. Jude Medical, St. Paul, Minnesota, United Healthcare, Minnetonka, Minnesota, and Novartis, Basel, Switzerland. Dr. Kosiborod has served as a consultant for Sanofi-Aventis, Paris, France and Boehringer-Ingelheim, Ingelheim, Germany.
PY - 2012/4/15
Y1 - 2012/4/15
N2 - Hospital-acquired anemia (HAA) is common, often develops in the absence of bleeding, and is associated with poor outcomes in patients with acute myocardial infarction (AMI). It is unknown whether red cell distribution width (RDW) and mean corpuscular volume (MCV), which are routinely available markers of iron deficiency, are associated with development of HAA during AMI. We studied 15,133 patients with AMI without anemia at admission. HAA was defined by nadir hemoglobin levels below age-, gender-, and race-specific thresholds and moderatesevere HAA was defined as nadir hemoglobin ≤11 g/dl. We examined the association between low MCV (<80 fL) and/or increased RDW (>15%) on patients' initial complete blood cell count and moderatesevere HAA using multivariable modified Poisson regression. Moderatesevere HAA was more common in patients with high RDW and low MCV (45.5%), high RDW and MCV ≥80 fL (33.0%), and normal RDW and low MCV (28.0%) than in those with normal RDW and MCV (18.3%, p <0.001). Compared to patients with normal RDW and MCV, those with increased RDW and low MCV (relative risk 1.72, 95% confidence interval 1.57 to 1.87), increased RDW and MCV ≥80 fL (relative risk 1.28, 95% confidence interval 1.16 to 1.42), or normal RDW and low MCV (relative risk 1.34, 95% confidence interval 1.08 to 1.65) were independently more likely to develop moderatesevere HAA. In conclusion, increased RDW and low MCV were independent predictors of moderatesevere HAA.
AB - Hospital-acquired anemia (HAA) is common, often develops in the absence of bleeding, and is associated with poor outcomes in patients with acute myocardial infarction (AMI). It is unknown whether red cell distribution width (RDW) and mean corpuscular volume (MCV), which are routinely available markers of iron deficiency, are associated with development of HAA during AMI. We studied 15,133 patients with AMI without anemia at admission. HAA was defined by nadir hemoglobin levels below age-, gender-, and race-specific thresholds and moderatesevere HAA was defined as nadir hemoglobin ≤11 g/dl. We examined the association between low MCV (<80 fL) and/or increased RDW (>15%) on patients' initial complete blood cell count and moderatesevere HAA using multivariable modified Poisson regression. Moderatesevere HAA was more common in patients with high RDW and low MCV (45.5%), high RDW and MCV ≥80 fL (33.0%), and normal RDW and low MCV (28.0%) than in those with normal RDW and MCV (18.3%, p <0.001). Compared to patients with normal RDW and MCV, those with increased RDW and low MCV (relative risk 1.72, 95% confidence interval 1.57 to 1.87), increased RDW and MCV ≥80 fL (relative risk 1.28, 95% confidence interval 1.16 to 1.42), or normal RDW and low MCV (relative risk 1.34, 95% confidence interval 1.08 to 1.65) were independently more likely to develop moderatesevere HAA. In conclusion, increased RDW and low MCV were independent predictors of moderatesevere HAA.
UR - https://www.scopus.com/pages/publications/84862796373
U2 - 10.1016/j.amjcard.2011.11.045
DO - 10.1016/j.amjcard.2011.11.045
M3 - Article
C2 - 22264598
AN - SCOPUS:84862796373
SN - 0002-9149
VL - 109
SP - 1104
EP - 1110
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -