Anemia in Patients with Acute Coronary Syndrome: Epidemiological Profile and Impact on the Prognosis

Anemia is an independent risk factor in coronary patients. We aimed to determine the relationship between hemoglobin levels and the evolution of patients admitted into the cardiology depart of Mongi Slim Hospital for acute coronary syndrome. This is a retrospective study of 300 patients hospitalized for acute coronary syndrome (122 patients with persistent ST segment elevation and 178 without ST elevation). The patients were subdivided into 2 groups: group A (30 anemic patients) with a hemoglobin level < 11 g/dl and group B (270 patients) with a hemoglobin level > 11 g/dl. Among the 300 patients, 256 were men (85%) and 44 were women (15%). The mean age was 59.5 ± 13.5 years. The anemic subjects were older than the non-anemic: 63 ± 9.9 years versus 57 ± 11 years. The renal function was more impaired in anemic patients with a clearance of creatinine to 54.66 ml per minute versus 93.62 ml per minute in non-anemic patients. Anemic patients had more frequently signs of left ventricular heart failure (46% versus 10%). Systolic left ventricular function, however, seemed unaffected by this rate with an ejection fraction measured at 55% in both anemic and non-anemic patients. Diastolic function was more often impaired with higher left ventricular filling pressures in anemic patients (66% versus 30%). The mean length of stay was longer for patients with anemia (12.5 ± 10.1 days versus 7.9 ± 4 days). The re-hospitalization rate was also higher in these patients. Anemia at admission for acute coronary syndrome is linked to a pejorative risk. A fairly strong relationship is found between low values of hemoglobin and the evolution of patients especially in terms of clinical or latent heart failure.