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...

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Autores: 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.
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2016
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/114645
Acceso en línea:https://hdl.handle.net/2445/114645
Access Level:acceso abierto
Palabra clave:Anèmia
Hemorràgia
Malalties coronàries
Comorbiditat
Factors de risc en les malalties
Anemia
Hemorrhage
Coronary diseases
Comorbidity
Risk factors in diseases
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spelling Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?Garay, AlbertoAriza Solé, AlbertFormiga Pérez, FrancescLorente, VictòriaSánchez-Salado, José C.Salazar-Mendiguchía, JoelRoura i Ferrer, GerardMuntané, GuillemAlegre Canals, OriolFuentes, LaraGómez Hospital, Joan AntoniCequier Fillat, Àngel R.AnèmiaHemorràgiaMalalties coronàriesComorbiditatFactors de risc en les malaltiesAnemiaHemorrhageCoronary diseasesComorbidityRisk factors in diseasesIntroduction 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.Elsevier2017201720162017info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion8 p.application/pdfhttps://hdl.handle.net/2445/114645Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1016/j.repc.2016.06.011Revista Portuguesa de Cardiologia, 2016, vol. 35, num. 12, p. 637-644https://doi.org/10.1016/j.repc.2016.06.011cc-by-nc-nd (c) Sociedade Portuguesa de Cardiologia , 2016http://creativecommons.org/licenses/by-nc-nd/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1146452026-05-29T05:05:01Z
dc.title.none.fl_str_mv Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?
title Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?
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
title_short 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_sort Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?
dc.creator.none.fl_str_mv 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 Garay, Alberto
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
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
dc.subject.none.fl_str_mv Anèmia
Hemorràgia
Malalties coronàries
Comorbiditat
Factors de risc en les malalties
Anemia
Hemorrhage
Coronary diseases
Comorbidity
Risk factors in diseases
topic Anèmia
Hemorràgia
Malalties coronàries
Comorbiditat
Factors de risc en les malalties
Anemia
Hemorrhage
Coronary diseases
Comorbidity
Risk factors in diseases
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.
publishDate 2016
dc.date.none.fl_str_mv 2016
2017
2017
2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/114645
url https://hdl.handle.net/2445/114645
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.repc.2016.06.011
Revista Portuguesa de Cardiologia, 2016, vol. 35, num. 12, p. 637-644
https://doi.org/10.1016/j.repc.2016.06.011
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Sociedade Portuguesa de Cardiologia , 2016
http://creativecommons.org/licenses/by-nc-nd/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Sociedade Portuguesa de Cardiologia , 2016
http://creativecommons.org/licenses/by-nc-nd/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname: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)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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