Peculiarities of the course of acute coronary syndrome in anemia according to the registry of the Regional Vascular Center of the Ryazan Region

INTRODUCTION: Anemia not only negatively affects the course and prognosis of acute coronary syndrome (ACS), but can also influence the choice of treatment. It seems relevant to study the regional features of the course and prognosis of ACS in combination with anemia.

AIM: To study the incidence and severity of anemia in patients with ACS, the features of the course and outcomes of ACS in patients with anemia according to the registry of the Regional Vascular Center of the Ryazan Region.

MATERIALS AND METHODS: A retrospective analysis of the ACS registry data for 2019 was performed, which included 242 patients: group 1 — patients with anemia (n = 52; 21.5%), group 2 — patients without anemia (n = 190; 78.5%). All analyzed data were obtained from the medical records of the inpatients.

RESULTS: Eighty five percent of patients in group 1 had mild, 11% — moderate, and 4% — severe anemia. Patients with ACS in combination with anemia were older (p = 0.0001). There were more women in the anemia group (p < 0.001), these patients more often had a history of myocardial infarction (p < 0.001), stroke (p = 0.03), angina (p = 0.009); they had lower blood pressure (p = 0.002 for systolic and p = 0.0004 for diastolic), glomerular filtration rate (p = 0.0005), left ventricular ejection fraction (p = 0.01). Killip class II heart failure was more often recorded in the presence of anemia (p = 0.009), the risk of in-hospital mortality according to the GRACE scale was also higher in patients with anemia (p < 0.001). Coronary angiography and percutaneous coronary intervention were more often performed in the group with ACS without anemia (p < 0.001 and p = 0.005 respectively). In-hospital mortality in patients with anemia exceeded that in patients without anemia (17.3% versus 7.9%, p = 0.04). Mild anemia was predominant among deceased patients (80.0%).

CONCLUSION: According to the ACS registry of the Regional Vascular Center for 2019, anemia was detected in 21.5% of patients, with mild anemia predominating. Patients with ACS and anemia more often had angina pectoris, postinfarction cardiosclerosis and stroke in history, and according to the GRACE scale, a higher risk of hospital mortality. They were less likely to undergo coronary angiography and percutaneous coronary intervention compared to patients with ACS without anemia. Hospital mortality was higher in the ACS group with anemia; among the deceased, mild anemia predominated.