Abstract 16594: Impact of Anemia on Long-Term Clinical Outcome in Patients With Mildly Reduced Left Ventricular Systolic Function After Acute Myocardial Infarction

Background: Anemia may confer a poor prognosis among patients with acute coronary syndrome. However, contemporary data are lacking on the prognostic importance of anemia in patients with mildly reduced left ventricular (LV) systolic function after acute myocardial infarction (AMI).

Methods: AMI patients receiving percutaneous coronary intervention were consecutively enrolled from January 2004 to August 2014. A total of 2,172 patients with mild LV systolic dysfunction: LV ejection fraction 40 49% as measured by echocardiography, were divided according to the presence of anemia. Anemia was defined as a hemoglobin level <14 g/dL in men and <12 g/dL in women. All-cause mortality within a follow-up period was compared in groups of patients with and without anemia.

Results: Median follow-up duration was 56.9 months (interquartile range 34.5 to 85.7 months). Patients with anemia were older, more likely to have diabetes and hypertension, but the two groups did not differ in sex and presence of dyslipidemia. The prescription rates of beta-blockers and angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists at discharge were similar in both groups, but those of potent P2Y12 inhibitors and statins were lower in patients with anemia. Patients with anemia had greater all-cause mortality (19.3% vs. 36.7%). Anemia was an independent predictor of all-cause mortality after adjusting confounding risk factors (hazard ratio: 1.301, confidence interval: 1.053-1.607, p=0.030).

Conclusion: In patients with mildly reduced LV systolic function after AMI, anemia is associated with poorer outcome independently of coexisting risk factors.