Zhang, Zhuxin, Jiang, Chao, He, Liu, Bai, Yu, Wu, Jiahui, Hu, Rong, Lv, Qiang, Ning, Man, Feng, Li, Tang, Ribo et al (show 6 more authors)
(2022)
Associations of anemia with death and major bleeding in patients with atrial fibrillation: A report from the Chinese Atrial Fibrillation Registry Study.
CLINICAL CARDIOLOGY, 45 (1).
pp. 91-100.
Abstract
<h4>Background</h4>Anemia is a common comorbidity in patients with atrial fibrillation (AF). Reports on the association of anemia and adverse events in patients with AF, especially from Asia, are limited.<h4>Methods and results</h4>Based on data from the Chinese Atrial Fibrillation Registry Study (CAFR), a total of 18,106 AF patients enrolled between August 2011 and December 2018 had hemoglobin (Hb) values recorded at baseline. Patients were classified into three groups according to Hb levels: 15,606 patients (86.2%) into the no anemia group (male Hb≥130 g/L; female Hb≥120 g/L), 1800 (9.9%) with mild anemia (male 110≤Hb<129 g/L; female 110≤Hb<119 g/L), and 700 (3.9%) with moderate to severe anemia (Hb≤109 g/L). Multivariable Cox regression models were used to determine if anemia was independently associated with all-cause death, cardiovascular death, or major bleeding, after adjusting for confounders. Anemia was present in 13.8% of the population at baseline. During a median follow-up of 4.01 years, the incidences of all-cause death (1.8, 4.9, and 8.9 per 100 person-years), cardiovascular death (1.0, 2.9, and 4.5 per 100 person-years), and major bleeding (0.5, 0.6, and 0.7 per 100 person-years) were gradually accentuated in patients with no anemia, mild anemia, and moderate to severe anemia, respectively. Compared with patients with no anemia, those with anemia had higher risks for all-cause death (mild anemia; adjusted hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.08-1.38; moderate to severe anemia; adjusted HR: 1.53, 95% CI: 1.31-1.77); and cardiovascular death (mild anemia; adjusted HR: 1.29, 95% CI: 1.10-1.52; moderate to severe anemia; adjusted HR: 1.27, 95% CI: 1.03-1.57), but not for major bleeding. The association between anemia and all-cause death was similar among subgroups stratified by sex, kidney function, anticoagulant, or ablation therapy.<h4>Conclusions</h4>Anemia was associated with increased risks of all-cause death, cardiovascular death, but no major bleeding in AF patients. The effect of anemia correction on the prognosis of patients with AF requires further study.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | atrial fibrillation, anemia, mortality, major bleeding |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 05 May 2022 15:51 |
| Last Modified: | 18 Jan 2023 21:04 |
| DOI: | 10.1002/clc.23764 |
| Open Access URL: | https://onlinelibrary.wiley.com/doi/10.1002/clc.23... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3154341 |
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