Characteristics, Management, and Short-Term Outcomes of Adults ≥65 years Hospitalized with Acute Myocardial Infarction with Prior Anemia and Heart Failure

Abstract Our study objectives were to examine the impact of anemia and heart failure (HF) on in-hospital complications and post-discharge outcomes (7 and 30-day rehospitalizations and mortality) in adults ≥65 years hospitalized with acute myocardial infarction (AMI). We used multivariable adjusted logistic regression models to examine the association between the presence of anemia and/or HF and the examined outcomes. The study population consisted of 3,863 patients ≥65 years hospitalized with AMI at the 3 major medical centers in Worcester, MA, during 6 annual periods between 2001 and 2011. Individuals were categorized into 4 groups based on the presence of previously diagnosed anemia (hemoglobin ≤10mg/dl) and/or HF: those without these conditions (n=2,300), those with anemia only (n=382), those with HF only (n=837), and those with both conditions (n=344). The median age of the study population was 79 years and 49% were men. Individuals who had been previously diagnosed with anemia and HF had the highest proportion of older adults (≥85 years) and the lowest proportion of those who had received any cardiac interventional procedure during hospitalization. After multivariable adjustment, individuals who presented with both previously diagnosed conditions were at greatest risk for experiencing adverse events. Patients who presented with HF only were at higher risk for developing several clinical complications during hospitalization, whereas those with anemia only were at slightly higher risk of being rehospitalized within 7-days of their index hospitalization. In conclusion, anemia and HF are prevalent chronic conditions that increased the risk of adverse events in older adults hospitalized with AMI.