Age and gender mediated the association between anemia and 30-day outcomes in patients with ST-segment elevated myocardial infarction
© 2024 The Authors..
Background: The higher prevalence of anemia in females and elderly may be attributed to its association with worsened outcomes in ST-elevation myocardial infarction (STEMI) patients. We aimed to evaluate the precise effects of age and gender on the association between anemia and 30-day outcomes.
Method: We identified 4350 STEMI patients and divided into anemia and non-anemia. Effects were analyzed as categories using Cox proportional-hazards regression and as continuous using restricted cubic splines. Propensity score matching (PSM) and mediation analysis were applied to identify intermediate effects.
Results: Anemic patients were older, more likely to be female, and experienced doubled all-cause death (7.3 % versus 15.0 %), main adverse cardiovascular and cerebrovascular events (MACCE, 11.1 % versus 20.2 %), heart failure (HF, 5.1 % versus 8.6 %), and bleeding events (2.7 % versus 5.4 %). After adjustment, the association between anemia and all-cause death (Hazard ratio (HR) 1.15, 95 % confidence interval (95 %CI) 0.93-1.14), MACCE (HR 1.14, 95 %CI 0.95-1.36) and HF (HR 1.19, 95 %CI 0.92-1.55) were insignificant, the effects persisted nullified across age classes (P-interaction > 0.05) and PSM (P > 0.05). Ulteriorly, age mediated 77.6 %, 66.2 %, 48.0 %, gender mediated 38.1 %, 15.0 %, 3.2 %, age and gender together mediated 99.8 % 72.9 %, 48.1 % of the relationship. Anemia was independently associated with bleeding events (HR 2.02, 95 %CI 1.42-2.88), the effects consisted significant regardless of PSM (P < 0.05), age, and gender classes (P-interaction > 0.05), and no mediating role of age and gender were observed.
Conclusions: In STEMI patients, age and gender largely mediated the relationship between anemia and all-cause death, MACCE, and HF, anemia was independently associated with bleeding complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
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| Enthalten in: |
International journal of cardiology. Heart & vasculature - 51(2024) vom: 27. März, Seite 101377 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wang, Shan [VerfasserIn] |
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| Links: |
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| Themen: |
Age |
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| Anmerkungen: |
Date Revised 12.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.ijcha.2024.101377 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369546970 |
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| 245 | 1 | 0 | |a Age and gender mediated the association between anemia and 30-day outcomes in patients with ST-segment elevated myocardial infarction |
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| 520 | |a © 2024 The Authors. | ||
| 520 | |a Background: The higher prevalence of anemia in females and elderly may be attributed to its association with worsened outcomes in ST-elevation myocardial infarction (STEMI) patients. We aimed to evaluate the precise effects of age and gender on the association between anemia and 30-day outcomes | ||
| 520 | |a Method: We identified 4350 STEMI patients and divided into anemia and non-anemia. Effects were analyzed as categories using Cox proportional-hazards regression and as continuous using restricted cubic splines. Propensity score matching (PSM) and mediation analysis were applied to identify intermediate effects | ||
| 520 | |a Results: Anemic patients were older, more likely to be female, and experienced doubled all-cause death (7.3 % versus 15.0 %), main adverse cardiovascular and cerebrovascular events (MACCE, 11.1 % versus 20.2 %), heart failure (HF, 5.1 % versus 8.6 %), and bleeding events (2.7 % versus 5.4 %). After adjustment, the association between anemia and all-cause death (Hazard ratio (HR) 1.15, 95 % confidence interval (95 %CI) 0.93-1.14), MACCE (HR 1.14, 95 %CI 0.95-1.36) and HF (HR 1.19, 95 %CI 0.92-1.55) were insignificant, the effects persisted nullified across age classes (P-interaction > 0.05) and PSM (P > 0.05). Ulteriorly, age mediated 77.6 %, 66.2 %, 48.0 %, gender mediated 38.1 %, 15.0 %, 3.2 %, age and gender together mediated 99.8 % 72.9 %, 48.1 % of the relationship. Anemia was independently associated with bleeding events (HR 2.02, 95 %CI 1.42-2.88), the effects consisted significant regardless of PSM (P < 0.05), age, and gender classes (P-interaction > 0.05), and no mediating role of age and gender were observed | ||
| 520 | |a Conclusions: In STEMI patients, age and gender largely mediated the relationship between anemia and all-cause death, MACCE, and HF, anemia was independently associated with bleeding complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Age | |
| 650 | 4 | |a Anemia | |
| 650 | 4 | |a Gender | |
| 650 | 4 | |a Mediation analysis | |
| 650 | 4 | |a ST-elevation myocardial infarction | |
| 700 | 1 | |a Zhang, You |e verfasserin |4 aut | |
| 700 | 1 | |a Qi, Datun |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xianpei |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Zhongyu |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Muwei |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Dayi |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Chuanyu |e verfasserin |4 aut | |
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