THE IMPACT OF THE CHANGE IN ANEMIA STATUS AFTER ACUTE MYOCARDIAL INFARCTION ON LONG-TERM PROGNOSIS

초록

Background It is well established that anemia is a predictor of poor prognosis in AMI patients, but it is not clear this is an effect of the low hemoglobin value per se. Methods The Korea Acute Myocardial Infarction Registry-National Institutes of Health is a prospective multicenter observational registry (n=5,505). The 3-year rates of composite outcomes of death, myocardial infarction (MI), or stroke were compared according to anemia status. Results We identified 1,033 (18.8%) anemic and 4,472 (81.2%) non-anemic patients at baseline. In patients without baseline anemia, the 3-year rates of death (adjusted hazard ratio [AHR]: 2.73; 95% confidence interval [CI]: 1.58 to 4.73) and composite outcome (AHR: 2.20; 95% CI: 1.50 to 3.24) were significantly higher in patients with developing anemia during 1-year after MI compared with persistent non-anemia after propensity matching. In anemic patients at baseline, anemia resolution during 1-year was associated with a lower risk of death (AHR: 0.44; 95% CI: 0.22 to 0.91) and composite outcome (AHR: 0.52; 95% CI: 0.32 to 0.84). For subgroup analysis, the risks of composite outcomes were the same with or without chronic kidney disease (CKD). Conclusion In the 3-year follow-up of patients with AMI, resolution of anemia within 1 year showed a more favorable prognosis than persistent or developing anemia. The change in anemia status on 3-year outcomes may have a discriminative capacity that early correction of anemia during 1-year after PCI can improve the adverse events