Author + information
- Bhaskar Bhardwaja,b,
- Yashashwi Pokharela,b,
- Kevin Kennedya,b,
- Adam Salisburya,b,
- Faraz Kureshia,b and
- John Spertusa,b
Introduction: In patients with MI, both hospital-acquired anemia (HAA) and acute kidney injury (AKI) are independently associated with mortality. Whether both HAA and AKI are independently associated with mortality, or interact with each other, is unknown
Methods: We defined HAA based on age, race, and gender specific hemoglobin levels during the hospitalization and AKI was defined as a rise in serum creatinine by ≥ 0.3 mg/dL in 48 hours. After excluding patients with missing hemoglobin, creatinine and with in-hospital CABG we grouped patients into 4 mutually exclusive categories based on the presence or absence of HAA and AKI in a 24-site US MI registry. Using Cox proportional hazards regression, we examined 5-year mortality in an adjusted model and examined the interaction of HAA and AKI with 5-year mortality.
Results: There were 1505, 1240, 78, 82 patients in groups by the presence of neither HAA nor AKI, HAA only, AKI only and both, respectively. Age, comorbidity burden, and GRACE scores increased when both conditions were coexisting. In unadjusted analyses, the HRs (95% CI) for death in patients with HAA only, AKI only and both were significant greater than patients without HAA or AKI (Figure). With sequential models, there was progressive attenuation of the HRs but here was no significant interaction of HAA and AKI on 5-year mortality
Conclusions: Although presence of both HAA and AKI after MI was associated with higher mortality risk than presence of either HAA or AKI, there was no acceleration in mortality risk.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-348
- 2017 American College of Cardiology Foundation