Association Between Haemoglobin Levels at Admission With Left Vetricular Ejection Fraction, Heart Failure, and Mortality in Acute

Myocard Infarct Patients at Moewardi Hospital Surakarta Yasa A.1, Doni2, Triady2, Ninik2, Wasiyanto2,Nugroho2, Fatoni2
1 2

Resident of Cardiology and Vascular Medicine Sebelas Maret University Department Cardiology and Vascular Medicine Sebelas Maret University Abstract

Background : Lower haemoglobin levels have been consistently associated with adverse cardiovascular outcomes in the acute myocard infarct patient. The aim of this study was to evaluate the relationship between haemoglobin levels during admission with left vetricular ejection fraction, heart failure, and mortality in acute myocard infarct patients. Methods : Inclusion criteria were acute myocard infarct patients Exclusion criteria were sign of bleeding and any known hematologic disorders. We used t test, mann whitney test, pearson and spearman correlation test for statistic, significant if p<0,05 Result : We conducted retrospective study during January until Juni 2013. There were 168 patients fullfilled criteria, 115 male and 33 female, mean age 58,60 + 12,26 years old, mean left vetricular ejection fraction 49,59 + 9,16%, mean haemoglobin 12,99 + 1,89 g/dL, 108 patients had heart failure, 25 patient death during hospitalized. There was positive correlation between left vetricular ejection fraction and haemoglobin levels (p=0,0001, r=0,619), negative correlation between heart failure and haemoglobin levels (p=0,0001, r=-0,694), and negative correlation between mortality and haemoglobin levels (p=0,0001, r=-0,358) Conclusion : This study demonstrates that increase haemoglobin levels was associated with increase left vetricular ejection fraction, decrease heart failure event, and lower mortality in acute myocard infarct patients at Moewardi Hospital Surakarta Keyword : haemoglobin, left vetricular ejection fraction, heart failure, acute myocard infarct

Table 1. Baseline characteristic patient No Variable 1 N -Heart Failure -mortality -Day mortality 2 Risk factor and comorbide -Diabetes mellitus -Hypertension -Smoking -Aritmia - AKI 3 Sex -male -female 4 Diagnose -STEMI - STEMI anterior - STEMI anterior extensive - STEMI inferior - STEMI anteroseptal - STEMI inferoposterior - others 5 Age 6 Killip 7 Grace 8 TIMI 9 Ejection Fraction 10 Hematocrite 11 Eritrochyte 12 Random blood glucose 13 Fasting glucose 14 2 h post prandial glucose 15 HbA1C 16 Natrium 17 Kalium 18 Albumin 19 Uric acid 20 troponin 22 CKMB 23 Hemoglobin 24 Leukosit 25 Thrombocyte 26 creatinin 27 ureum

Mean + SD 168 108 25 2,89 + 1,81 48 93 113 61 31 115 33 14 38 27 44 30 14 2 58,60 + 12,26 2,09 + 0,18 119,55 + 33,35 5,5952 2,86678 49,59 + 9,16 38,97 + 5,71 4,50 + 0,63 193,98 + 94,13 125,06 + 45,55 153,05 + 53,24 6,40 + 1,70 137,66 + 3,61 4,02 + 0,88 4,02 + 0,649 6,58 + 2,01 4,32 + 7,25 44,37 + 54,73 12,99 + 1,89 11,95 + 3,45 255,39 + 64,53 1,52 + 0,69 55,44 + 40,82

Table 2. Statistic test result Variable Ejection Fraction Vs Hemoglobin heart failure Vs Hemoglobin mortality Vs Hemoglobin

Compare mean P=0,001 P=0,001 P=0,001

correlation p=0,0001, r=0,619 p=0,0001, r=-0,694 p=0,0001, r=-0,358

One-Sample Test Test Value = 0 t df Sig. (2-tailed) Mean Difference 95% Confidence Interval of the Difference Lower Ejection Fraction Hemoglobin 70,177 88,691 167 167 ,000 ,000 49,59524 12,99821 48,2000 12,7089 Upper 50,9905 13,2876

Correlations Meninggal Correlation Coefficient Spearman's rho Meninggal Sig. (2-tailed) N 1,000 . 168 Hemoglobin ,358
**

,000 168

Correlation Coefficient Hemoglobin Sig. (2-tailed) N **. Correlation is significant at the 0.05 level (2-tailed). Correlations

,358

**

1,000 . 168

,000 168

Hemoglobin Correlation Coefficient Hemoglobin Spearman's rho Correlation Coefficient Heart Failure Sig. (2-tailed) N **. Correlation is significant at the 0.05 level (2-tailed). Correlations Hemoglobin Pearson Correlation Hemoglobin Sig. (2-tailed) N Pearson Correlation Ejection Fraction Sig. (2-tailed) N 168 ,619
**

Heart Failure ,694

**

1,000 . 168 ,694

**

Sig. (2-tailed) N

,000 168 1,000 . 168

,000 168

Ejection Fraction 1 ,619

**

,000 168 1

,000 168 168