Association between Hemoglobin Levels and Severity of Coronary Artery Disease among Patients Presenting with ST- Segment Elevation Myocardial Infarction

  • Kaleem Ullah Shaikh Department of Cardiology, Liaquat National Hospital and Medical College, Pakistan
  • Abeer Sarfaraz Department of Cardiology, Liaquat National Hospital and Medical College, Pakistan
  • Sana Sarfaraz Department of Pharmacy and Pharmaceutical Sciences, University of Karachi, Pakistan
  • Muhammad Wasiq Anwar Department of Cardiology, Liaquat National Hospital and Medical College, Pakistan
  • Falaknaz Nizarali Department of Cardiology, Liaquat National Hospital and Medical College, Pakistan
  • Lubna Mustufa Department of Cardiology, Liaquat National Hospital and Medical College, Pakistan
Keywords: Acute Coronary Syndrome, ST-Elevation Myocardial Infarction, Anemia, Hemoglobin

Abstract

Objective: This study aimed to elucidate the association between hemoglobin levels (anemia) and the severity of coronary artery disease (CAD) among patients experiencing ST-segment elevation myocardial infarction (STEMI).

Methods: This prospective cohort study included patients aged 20 to 80 years presenting with STEMI to Liaquat National Hospital and Medicare General and Cardiac Hospitals between September 2023 and February 2024. Anemia was categorized as per the criteria defined by the World Health Organization based on hemoglobin levels. The severity of CAD was assessed based on the number of vessels affected and the Syntax Score system derived from coronary angiography.

Results: Results: Of the 228 patients, 122 were anemic based on hemoglobin levels. The Syntax Score was significantly higher in the anemic group compared to the non-anemic group (27.97±7.15 vs. 24.62±7.04, p<0.01). One-way ANOVA showed significant differences in mean Syntax Scores across anemia severity levels, with the severely anemic group having the highest scores (F(3, 224) = 4.310, p = 0.006). Logistic regression indicated that lower hemoglobin levels were significantly associated with higher CAD severity (β = -0.556, t = -2.284, p = 0.023), and male gender also correlated with higher Syntax Scores (β = 2.294, t = 2.165, p = 0.031). The ROC curve analysis revealed an area under the curve (AUC) of 0.537, indicating that hemoglobin alone is not a strong predictor of multivessel disease in this population.

Conclusion: Lower hemoglobin levels are significantly associated with increased severity of CAD in patients with STEMI, emphasizing the need for careful anemia management in CAD patients.

Published
2025-01-06
Section
Original Articles