Elsevier

The American Journal of Cardiology

Volume 154, 1 September 2021, Pages 54-62
The American Journal of Cardiology

Effect of Anemia on the Prognosis of Patients with Ventricular Tachyarrhythmias

https://doi.org/10.1016/j.amjcard.2021.05.045Get rights and content

This study evaluates the prognostic impact of anemia in patients presenting with ventricular tachyarrhythmias. The present longitudinal, observational, registry-based, monocentric cohort study included retrospectively all consecutive patients presenting with ventricular tachyarrhythmias on admission from 2002 to 2016. Anemic patients (hemoglobin levels <12.0 g/dl) were compared with non–anemic patients (hemoglobin levels ≥12.0 g/dl). The primary endpoint was all-cause mortality at 2.5 years. Secondary endpoints were cardiac death at 24 hours, all-cause mortality at index hospitalization, and the composite endpoint of cardiac death at 24 hours, recurrent ventricular tachyarrhythmias, and appropriate ICD therapies at 2.5 years. A total of 2,184 consecutive patients were included, of whom 30% were anemic and 70% non–anemic. Anemia was associated with the primary endpoint of all-cause mortality at 2.5 years (65% vs 29%, p = 0.001; HR = 2.441; 95% CI 2.086 to 2.856), cardiac death at 24 hours (26% vs 11%, p = 0.001), all-cause mortality at index hospitalization (45% vs 20%, p = 0.001), and the composite endpoint (35% vs 27%, p = 0.001; HR = 2.923; 95% CI 2.564 to 4.366). After multivariable adjustment, anemia was no longer associated with the composite endpoint. Predictors of adverse prognosis for anemics were CKD (HR = 2.191), LVEF <35% (HR = 1.651), cardiogenic shock (HR = 1.591), CPR (HR = 1.460), male gender (HR = 1.379), and age (HR = 1.017). In conclusion, anemic patients presenting with ventricular tachyarrhythmias were associated with increased long-term mortality at 2.5 years but not with the composite arrhythmic endpoint at 2.5 years. Predictors of adverse prognosis at 2.5 years were CKD, LVEF <35%, cardiogenic shock, CPR, male gender, and age.

Section snippets

Methods

The present study retrospectively included all consecutive patients with ventricular tachyarrhythmias from 2002 until 2016, as recently published.10, 11, 12

For the present analysis, risk stratification was performed according to anemia. Anemic patients (hemoglobin levels <12.0 g/dl) were compared with non–anemic patients (hemoglobin levels ≥12.0 g/dl). To allow for a better comparison than previous studies, anemia was defined as hemoglobin (Hb) levels <12.0 g/dl, independent of gender.8 Overall

Results

A total of 2,184 consecutive patients presenting with ventricular tachyarrhythmias on admission were included in the present study. Of these, 30% were anemic, and 70% were non–anemic. As outlined in Table 1, ventricular tachycardia (VT) and ventricular fibrillation (VF) were distributed equally (VT: 55% vs 58%; VF: 45% vs 42%). In general, anemic patients showed higher rates of CPR (59% vs 41%, p = 0.001), mainly attributed to in-hospital CPR (38% vs 13%, p = 0.001), whereas non–anemic patients

Discussion

The present study evaluated the frequency and types of anemia, as well as their prognostic impact on patients presenting with ventricular tachyarrhythmias on admission. Anemia was found in 30% of these patients. The most common type of anemia was hemorrhagic (29%), followed by hypoproliferative (27%), and mild forms of anemia (20%). Of anemic patients presenting with ventricular arrhythmias, 10% suffered cardiac death at 24 hours after admission. Hemolytic and undefined anemia after completed

Disclosures

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this study.

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