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Anemia Is Associated With Increased One-Year Mortality and Ischemic Events in Patients With ACS: Results From the ACUITY Trial. Steven V. Manoukian, George D. Dangas, Michele D. Voeltz, Frederick Feit, Roxana Mehran, and Gregg W. Stone
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Anemia Is Associated With Increased One-Year Mortality and Ischemic Events in Patients With ACS: Results From the ACUITY Trial Steven V. Manoukian, George D. Dangas, Michele D. Voeltz, Frederick Feit, Roxana Mehran, and Gregg W. Stone Emory University School of Medicine, Atlanta, GA; Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY; New York University School of Medicine, New York, NY
UFH or Enoxaparin + GP IIb/IIIa Bivalirudin + GP IIb/IIIa Angiography within 72h R* Bivalirudin Alone STUDY DESIGN • The ACUITY Trial randomized 13,819 patients with moderate and high-risk NSTE-ACS. Medical management Moderate- high risk ACS PCI Aspirin in all Clopidogrel dosing and timing per local practice CABG
PNI <0.001 PSup = 0.015 PNI <0.001 PSup <0.001 PNI = 0.011 PSup = 0.32 ACUITY Primary Results – 30 Days
BACKGROUND & OBJECTIVES • Baseline anemia is associated with an increased risk of short-term (30-day) ischemic complications and mortality in ACS. Whether anemia adversely impacts long-term outcomes is less clear. • Anemia was defined using WHO criteria: - hgb <13 g/dL men - hgb <12 g/dL women • We assessed the impact of anemia on rates of long-term (1-year) ischemic events and mortality in patients with ACS in the ACUITY trial.
P=<0.0001 P=<0.0001 P=<0.0001 Anemic vs Non-Anemic Population 30-Day Event Rates
Anemic vs Non-Anemic Population: 1-Year Ischemic Event Rates P<0.0001
P=0.74 P=0.59 P=0.71 P=0.77 P=0.81 P=0.052 Anemic Population 30-Day Event Rates by Treatment
Anemic vs Non-Anemic Population: 1-Year Mortality P<0.0001
Baseline Independent Predictors of 1-Year Mortality HR ±95% CI HR (95% CI)
CONCLUSIONS • Anemia is not uncommon in patients with ACS (16.9%). • Anemia is associated with a significant increase in rates of long-term (1-year) ischemic events. • Anemia is associated with an over 2-fold increase in rates of long-term (1-year) mortality and is an independent predictor of long-term (1-year) mortality in patients with ACS.