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Acute coronary syndromes in the elderly: prognostic impact of anaemia
Session:
Posters - E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Speaker:
Ana Rita Gomes
Congress:
CPC 2021
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Ana Rita M. Gomes; Carolina Saleiro; Diana de Campos; João Gameiro; José Pedro Sousa; Natália António; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="color:black">INTRODUCTION:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:black">The increase in life expectancy is a reality and cardiovascular disease incidence rises with it. The elderly are fragile patients with high prevalence of multiple comorbidities. Anaemia is one of them and, in most cases, has multifactorial causes. After an acute coronary syndrome (ACS), the thrombotic versus haemorrhagic risks in these patients are hard to balance. The aim of this study is to evaluate prognostic impact of anaemia in the elderly after an ACS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="color:black">METHODS:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:black">Retrospective analysis of consecutive patients admitted to a single Intensive Coronary Unit between 2009 and 2016 with the diagnosis of ACS. Patients younger than 80 years old were excluded. A complete blood count was collected upon admission and anaemia was defined for haemoglobin values below 12.5mg/dL. Cox regression analysis and Kaplan-Meier curves were conducted to determine prognostic value of anaemia in this specific population. Multivariate analysis with other comorbidities and antithrombotic therapy was also performed.</span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="color:black">RESULTS:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:black">A total of 353 patients (median age of 84.0±6.0 years old; 52.1% males; 51.3% with anaemia) were enrolled. In cox regression analysis, anaemia predicted mortality (HR 1.614, 95% CI 1.199-2.172, P=0.002). In multivariate analysis – including gender, presence of hypertension, diabetes, chronic kidney disease and atrial fibrillation (AF) at admission, anaemia proved to be an independent predictor of mortality (HR 1.521, 95% CI 1.119-2.069, P=0.007). Adding all previous and discharge antithrombotic therapy – antiplatelet agents and oral anticoagulants – to the equation, anaemia maintained its prognostic value (HR 2.157, 95% CI 1.130-4.116, P=0.020). Both AF and being discharged from the hospital with ticagrelor also increased mortality risk in these patients (HR 2.188, 95% CI 1.177-4.070, P=0.130 for AF; HR 1.906, 95% CI 1.011-3.594, P=0.046 for ticagrelor at discharge).</span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="color:black">CONCLUSIONS:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:black">After an ACS, anaemia proved to be an independent predictor of mortality in the elderly. This emphasizes the importance of its adequate aetiology investigation and treatment and careful selection of antithrombotic therapy following an ACS.</span></span></span></p>
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