CAUSES OF LOW HAEMOGLOBIN LEVEL IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Background: Anaemia is common in patients admitted with acute myocardial infarction (AMI) and can badly affect the short and long term outcomes. Hospital acquired anaemia (HAA) is a type of anaemia which develops in patients during hospitalization with a normal haemoglobin level at the time of admission. There is very scant data regarding the causes for hospital acquired anaemia. This study was conducted in order to determine the causes and baseline characteristics of low haemoglobin level in AMI. Methods: This descriptive study was performed in Lady Reading Hospital Peshawar from 1st June 2013 to 31st May 2014. All the patients with AMI having normal baseline haemoglobin level at admission were included. Haemoglobin was rechecked on 5th day of admission to see whether patient develops HAA or not. Results: A total of 456 consecutive patients with AMI were screened for low haemoglobin. Low haemoglobin level (haemoglobin <12 g/dl in female and <13 g/dl in male) on 4th day of admission was found in 84 patients. The mean age of these 84 patients were 59.4±12.4 years, 39 (46.4%) were female and 45 (54%) were male. Patients with age >70 years were 12 (14.3%). hypertensives were 34 (40.5%), diabetics were 24 (28.6%), CKD was seen in 11 (13.1%), dyslipidemia in 17 (20.2%), and smokers were 16 (19%). Upper GI bleed was found in 23 (27%), lower GI bleed in 7 (8.3%), hematuria in 6 (7.1%), possible coronary intervention in 7 (8.3%), and more than one cause in 14 (16.6%) patients, while no cause was found in 27 (32.14%) patients. Conclusion: One third of patients had no discernible cause of low haemoglobin, while one fourth of patients had isolated upper GI bleed as the main cause for hospital acquired low Hb.
Keywords: Acute MI, Hospital acquired anaemia (HAA), GI bleed, Haemoglobin
Pak J Physiol 2017;13(2):22–4
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