The impact of concomitant anemic syndrome on the clinical course of coronary artery disease

Abstract

The presence of comorbid pathology negatively affects the prognosis of patients with coronary artery disease (CAD). Today it is important to clarify the features of CAD on the background of concomitant anemia and identify the main risk factors for complications to improve the tactics of this category of patients. The aim. To investigate the influence of concomitant anemic syndrome on the clinical course of coronary artery disease, frequency and features of the main cardiovascular events. Materials and methods. The study involved 91 patients with coronary artery disease (42 men and 49 women, age – 70 (49; 93)). All patients were divided into 2 groups: the main group (n = 46) consisted of patients with coronary artery disease with iron-deficiency anemia, the comparison group (n = 45) – patients with coronary artery disease without iron-deficiency anemia. The study of the main cardiovascular events took into account re-hospitalization due to arrhythmic disorders, progression of heart failure (HF), CAD destabilization within the observed period (1 year), as well as death from cardiovascular causes. The data analysis was performed using Statistica 13.0. Results. During the year, 42 non-fatal cardiovascular events were noted in patients of both groups, however in the main group their total number was 30 (67 %) versus 12 (27 %) in the comparison group (χ2 = 13.603; P < 0.05). The presence of concomitant anemia in CAD patients significantly increased the relative risk of re-hospitalizations (RR = 1.9; 95 % CI 1.230–3.112; P < 0.05). Among the reasons for hospitalization in the main group, HF decompensation prevailed – 17 (57 %) patients, unstable angina – 7 (23 %), arrhythmic disorders – 6 (20 %); in the comparison group, among the reasons for re-hospitalization, 7 (57 %) had HF decompensation, 3 (25 %) had unstable angina, and 2 (17 %) cases had arrhythmic disorders. In total, 9 (19.5 %) deaths were recorded in the main group, while in the comparison group 1 (2.2 %) death was recorded during the year (χ2 = 6.995; P < 0.05). The presence of concomitant anemia in patients with CAD increases the risk of fatal outcome by 8.8 times (RR = 8.8; 95 % CI 1.162–66.685; P < 0.05). The presence of moderate anemia in patients with CAD significantly increases the incidence of combined critical events by 39 % during the year of follow-up compared with mild anemia (χ2 = 12.843; P < 0.05). Conclusions. The presence of concomitant anemia is associated with a worsened prognosis for patients having coronary artery disease due to an increased risk of non-fatal cardiovascular events that require re-hospitalization during the year of observation, and an increased incidence of death. Increasing severity of anemia is associated with an increase in the frequency of the combined critical event during 1 year of follow-up.