The relationship between admission hemoglobin level and and left ventricular systolic functions in patients with first ST-segment elevated myocardial infarction

OBJECTIVES
The goal of this study was to evaluate the relationship between admission hemoglobin levels and left ventricular systolic functions in patients admitted with first ST-segment elevated myocardial infarction (STEMI).

STUDY DESIGN
The study was conducted prospectively in three centers in 483 consecutive patients (402 men, 81 women; mean age 56.5±11.2 years; range 24 to 74 years) with first STEMI. All patients were evaluated by echocardiography after a mean of 2.4 days of admission. Evaluation of left ventricular systolic functions included measurements of ejection fraction (EF), wall motion score index (WMSI), and tissue Doppler S wave velocities at four different localizations (anterior, inferior, lateral, posterior septum). Hemoglobin levels were measured within one hour of admission. Anemia was defined according to the World Health Organization criteria (hemoglobin <13.0 g/dl in men and <12.0 g/dl in women). Echocardiographic characteristics of the patients with and without anemia were compared.

RESULTS
Anemia was detected in 67 patients (13.9%). There were no significant differences between patients with and without anemia with respect to left ventricular end-systolic and end-diastolic diameters, wall thickness, WMSI, and EF. The mean EF in the anemic group (47.5%) was lower than that of the patients without anemia (48.5%), but this difference was not significant. All Sm velocities were lower in the anemic group, but only septal mitral annular Sm velocity reached statistical significance (p=0.048). There was no correlation between hemoglobin levels and EF (r=0.027, p=0.55).

CONCLUSION
Our findings suggest that mild to moderate anemia has no deleterious effect on systolic function in patients with first STEMI.