Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?
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- 作者：Alberto Garay ; Albert Ariza-Solé ; ; aariza@bellvitgehospital.cat ; Francesc Formiga ; Victoria Lorente ; José ; C. Sá ; nchez-Salado ; Joel Salazar-Mendiguchí ; a ; Gerard Roura ; Guillem Muntané ; Oriol Alegre ; Lara Fuentes ; Joan A. Gó ; mez-Hospital ; Angel Cequier
- 关键词：Bleeding risk stratification ; Acute coronary syndromes ; Anemia ; Comorbidities
- 刊名：Revista Portuguesa de Cardiologia
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：35
- 期：12
- 页码：637-644
- 全文大小：792 K
- 卷排序：35
文摘
Anemia is a common comorbidity in patients with acute coronary syndromes (ACS), and is associated with higher risk for both bleeding and ischemic complications. We aimed to assess the predictive ability of bleeding risk scores (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines [CRUSADE], Mehran and Acute Coronary Treatment and Intervention Outcomes Network [ACTION]) in ACS patients with anemia.MethodsAll consecutive ACS patients were prospectively included. The primary outcome was in-hospital major bleeding according to the CRUSADE, Mehran and ACTION definitions. Anemia was defined as hemoglobin <130 g/l in men and <120 g/l in women. The predictive ability of the bleeding risk scores was assessed by binary logistic regression, calculating receiver operating characteristic (ROC) curves and their corresponding area under the curve (AUC).ResultsWe included 2255 patients, mean age 62.4 years. Anemia was present in 550 patients (24.4%). Patients with anemia had a significantly higher prevalence of comorbidities. The three bleeding risk scores adequately predicted major bleeding in the whole cohort.No significant differences were observed regarding the predictive ability of each of the scores in patients with and without anemia (CRUSADE: AUC 0.73 without anemia vs. 0.74 with anemia, p=0.913; ACTION: AUC 0.68 without anemia vs. 0.73 with anemia, p=0.353; Mehran: AUC 0.69 without anemia vs. 0.61 with anemia, p=0.210). Only the Mehran score showed significantly lower predictive ability in patients with hemoglobin <11 g/dl (AUC 0.51, p=0.044).ConclusionsAnemia was a common comorbidity in patients with ACS from our series. Currently available bleeding risk scores showed an adequate predictive ability in patients with mild anemia.