Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?
Introduction and objective: 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 an...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Accepted version |
| Publication date: | 2016 |
| Country: | España |
| Institution: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repository: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:2445/114645 |
| Online Access: | https://hdl.handle.net/2445/114645 |
| Access Level: | Open access |
| Keyword: | Anèmia Hemorràgia Malalties coronàries Comorbiditat Factors de risc en les malalties Anemia Hemorrhage Coronary diseases Comorbidity Risk factors in diseases |
| _version_ | 1878740805187796992 |
|---|---|
| author | Garay, Alberto |
| author2 | Ariza Solé, Albert Formiga Pérez, Francesc Lorente, Victòria Sánchez-Salado, José C. Salazar-Mendiguchía, Joel Roura i Ferrer, Gerard Muntané, Guillem Alegre Canals, Oriol Fuentes, Lara Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. |
| author2_role | author author author author author author author author author author author |
| author_browse | Alegre Canals, Oriol Ariza Solé, Albert Cequier Fillat, Àngel R. Formiga Pérez, Francesc Fuentes, Lara Garay, Alberto Gómez Hospital, Joan Antoni Lorente, Victòria Muntané, Guillem Roura i Ferrer, Gerard Salazar-Mendiguchía, Joel Sánchez-Salado, José C. |
| author_facet | Garay, Alberto Ariza Solé, Albert Formiga Pérez, Francesc Lorente, Victòria Sánchez-Salado, José C. Salazar-Mendiguchía, Joel Roura i Ferrer, Gerard Muntané, Guillem Alegre Canals, Oriol Fuentes, Lara Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. |
| author_role | author |
| collection | Recercat. Dipósit de la Recerca de Catalunya |
| description | Introduction and objective: 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. Methods: All 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). Results: We 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). Conclusions: Anemia 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_d9bb8a62bf3eafd4e2dd3a84fc1c302e |
| institution | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| instname_str | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:recercat.cat:2445/114645 |
| publishDate | 2016 |
| publishDateSort | 2016 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| reponame_str | Recercat. Dipósit de la Recerca de Catalunya |
| spelling | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? Garay, Alberto Ariza Solé, Albert Formiga Pérez, Francesc Lorente, Victòria Sánchez-Salado, José C. Salazar-Mendiguchía, Joel Roura i Ferrer, Gerard Muntané, Guillem Alegre Canals, Oriol Fuentes, Lara Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. Anèmia Hemorràgia Malalties coronàries Comorbiditat Factors de risc en les malalties Anemia Hemorrhage Coronary diseases Comorbidity Risk factors in diseases Introduction and objective: 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. Methods: All 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). Results: We 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). Conclusions: Anemia 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. Elsevier https://hdl.handle.net/2445/114645 |
| spellingShingle | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? Garay, Alberto Anèmia Hemorràgia Malalties coronàries Comorbiditat Factors de risc en les malalties Anemia Hemorrhage Coronary diseases Comorbidity Risk factors in diseases |
| status_str | acceptedVersion |
| title | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| title_full | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| title_fullStr | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| title_full_unstemmed | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| title_short | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| title_sort | Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes? |
| topic | Anèmia Hemorràgia Malalties coronàries Comorbiditat Factors de risc en les malalties Anemia Hemorrhage Coronary diseases Comorbidity Risk factors in diseases |
| topic_facet | Anèmia Hemorràgia Malalties coronàries Comorbiditat Factors de risc en les malalties Anemia Hemorrhage Coronary diseases Comorbidity Risk factors in diseases |
| url | https://hdl.handle.net/2445/114645 |