Thirty-Day Mortality Frequency in Acute Coronary Syndrome Patients with   Varying Hematocrit Levels

Authors

  • Sakha Muqeet Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan
  • Salman Ijaz Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan
  • Asma Razzaq Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan
  • Badr Mansoor Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan
  • Salman Munir Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan
  • Masood Ali Akbar Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-7.13615

Keywords:

Acute Coronary Syndrome, Anemia, Hemoglobin, Hematocrit, Mortality

Abstract

Objective: To find the frequency of various hematocrit levels in patients of acute coronary syndrome (ACS) and to compare the frequency of 30-day mortality in patients of ACS with varying hematocrit levels.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Emergency department, Punjab Institute of Cardiology, Lahore, Pakistan, from Dec 2024 to May 2025.

Methodology: A total of 150 patients with ACS were taken into consideration for the study. Five ml of blood were taken for assessment of hematocrit and hemoglobin levels at baseline and compared with reference ranges. Patients were called after 30 days for follow-up. If patients died during the first 30 days, their mortality was recorded.

Results: The mean age of patients was 55.27±10.56 years. Out of 150 patients, 109 (72.67%) were males. Normal, low, and high hematocrit levels were noted in 90(60%), 50(33.33%), and 10(6.67%) patients, respectively. In patients having low hematocrit levels, mortality occurred in 8(16%) patients, and in patients having high hematocrit levels, mortality occurred in 9(90%) patients (p-value <0.001)

Conclusion: The frequencies of normal, low, and high hematocrit levels were 60%, 33.3% and 6.67%, respectively. Furthermore, it is concluded that hematocrit levels are significantly associated with mortality within 30 days of ACS.

Downloads

Download data is not yet available.

References

1. Yurdam FS, Kiş M. The relationship between TIMI flow and MAPH score in patients undergoing primary percutaneous coronary intervention for STEMI. Int Heart J 2023; 64(5): 791-797.

https://doi.org/10.1536/ihj.23-024

2. Ahmed S, Shah GA, Saghir T, Ahmed S, Mueed A, Roy N. The crowd of acute coronary syndrome in a rural emergency room of Pakistan: distribution of demographic, clinical and angiographic characteristics. Pak Heart J 2022; 55(4): 351-356.

https://doi.org/10.47144/phj.v55i4.2346

3. Duran LP, Sabella-Jiménez V. ST-Segment Elevation Myocardial Infarction and Bleeding Complications in JAK2-Negative Polycythemia. Texas Heart Inst J 2023; 50(5): e238148.

http://doi.org/10.14503/THIJ-23-8148

4. Kwon SS, Yoon SY, Bang DW, Kim H, Kim KH, Lee MH, et al. Association of Higher Hemoglobin Level With Significant Carotid Artery Plaque in the General Population. Journal of lipid and atherosclerosis 2024; 13(2): 184-193.

http://doi.org/10.12997/jla.2024.13.2.184

5. Abouomar MA, Hassan TM, Alaarag AF. Anemia at Admission and Clinical Outcomes in Patients with Acute ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Iranian Heart J 2021; 22(2): 58-67.

6. Giannitsis E, Blankenberg S, Christenson RH, Frey N, von Haehling S, Hamm CW, et al. Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome. Clin Res Cardiol 2021; 110: 1-16.

https://doi.org/0.1007/s00392-021-1821-2

7. Meah MN, Mills NL, Adamson PD, Newby DE. The 2020 European Society of cardiology non-ST-segment elevation acute coronary syndromes guideline: the good, the bad and the ugly. Heart 2021; 107(6): 444-446.

https://doi.org/10.1136/heartjnl-2020-318195

8. Zada S, Nazir P, Kumari S, Bai B, Khan S, Haq Eu et al. Clinical Profile and Outcome in Patients with Acute Coronary Syndrome (ACS) with Left Main Disease Presenting at Tertiary Care Hospital Karachi, Pakistan. Pak J Cardiovasc Interv 2024; 4(2): 30-38. http:/doi.org/10.58889/PJCVI.7.30.38

9. Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al-Suwaidi S, AlKatheeri R, et al. Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus 2020; 12(7): e9349. http://doi.org/10.7759/cureus.9349

10. Díez-Villanueva P, Jiménez-Méndez C, Cepas-Guillén P, Arenas-Loriente A, Fernández-Herrero I, García-Pardo H, et al. Current Management of Non-ST-Segment Elevation Acute Coronary Syndrome. Biomedicines 2024; 12(8): 1736.

https://doi.org/10.3390/biomedicines12081736

11. Zhang L, Li X. Acute Normovolemic Hemodilution in a Patient with Severe Peripheral Arterial Disease: A Rare Case Report. Int J Anesth Clin Med 2023; 11(1): 58-61.

http://www.sciencepublishinggroup.com/j/ijacm

12. Wang H, Lin C, Zhang W, Wei F, Xu Y, Wang C et al. Effect of acute hypervolemic hemodilution with bicarbonated Ringer’s solution on perioperative S100β and NSE in elderly patients undergoing spine surgery. Biotech Genet Eng Rev 2024; 40(4): 4849-4861. https://doi.org/10.1080/02648725.2023.2216970

13. Mahmoodi MR, Kimiagar SM, Abadi AR. Is anemia an independent predictor of occurrence of acute coronary syndrome? Results from the Modares Heart Study. Am Heart Hospital J 2007; 5(2): 73-79.

https://doi.org/10.1111/j.541-9215.2007.06110.x

14. Rogers WJ, Frederick PD, Stoehr E, Canto JG, Ornato JP, Gibson CM, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Am Heart J 2008; 156(6): 1026-1034. http://doi.org/10.16/j.ahj.2008.07.030

15. Bodolea C, Hiriscau EI, Buzdugan E-C, Grosu AI, Stoicescu L, Vesa Ş, et al. The Association between Peripheral Blood Cells and the Frailty Syndrome in Patients with Cardiovascular Diseases. Endocr Metab Immune Disord Drug Targets 2020; 20(9): 1419-1433.

http://doi.org/10.2174/1871530320666200813135905

16. Ali Q, Shahid N, Khan M, Qaisar F, Khaliq M. Frequency of 30 days mortality in patients of ST-segment. Biol Clin Sci Res J 2023; 2023(310): 1-4. https://doi.org/10.54112/bcsrj.v2023i1.310

17. Burch GE. Of bloodletting. Am Heart J 1979; 98(5): 666.

http://doi.org/10.1016/0002-8703(79)90295-3

18. Wu WC, Rathore SS, Wang Y, Radford MJ, Krumholz HM. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001; 345(17): 1230-1236.

http://doi.org/10.056/NEJMoa010615

19. Lipšic E, van der Horst IC, Voors AA, van der Meer P, Nijsten MW, van Gilst WH, et al. Hemoglobin levels and 30-day mortality in patients after myocardial infarction. Int J Cardiol 2005; 100(2): 289-2892.

http://doi.org/10.1016/j.ijcard.2004.10.043

20. Greenberg G, Assali A, Vaknin-Assa H, Brosh D, Teplitsky I, Fuchs S, et al. Hematocrit level as a marker of outcome in ST-segment elevation myocardial infarction. Am J Cardiol 2010; 105(4): 435-440.

http://doi.org/10.1016/j.amjcard.2009.10.016

21. Arant CB, Wessel TR, Olson MB, Bairey Merz CN, Sopko G, Rogers WJ, et al. Hemoglobin level is an independent predictor for adverse cardiovascular outcomes in women undergoing evaluation for chest pain: results from the National Heart, Lung, and Blood Institute Women's Ischemia Syndrome Evaluation Study. J Am Coll Cardiol 2004; 43(11): 2009-14.

http://doi.org/10.1016/j.jacc.2004.01.038

22. Rao SV, Jollis JG, Harrington RA, Granger CB, Newby LK, Armstrong PW, et al. Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes. JAMA 2004; 292(13): 1555-1562.

23. Wu WC, Schifftner TL, Henderson WG, Eaton CB, Poses RM, Uttley G, et al. Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. J Am Med Assoc 2007; 297(22): 2481-2488.

http://doi.org/10.1001/jama.297.22.2481

24. Sabatine MS, Morrow DA, Giugliano RP, Burton PB, Murphy SA, McCabe CH, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation 2005; 111(16): 2042-2049.

25. Welch HG, Meehan KR, Goodnough LT. Prudent strategies for elective red blood cell transfusion. Ann Intern Med 1992; 116(5): 393-402. http://doi.org/10.7326/0003-4819-116-5-393

Downloads

Published

29-11-2025

Issue

Section

Original Articles

Categories

How to Cite

1.
Muqeet S, Ijaz S, Razzaq A, Mansoor B, Munir S, Akbar MA. Thirty-Day Mortality Frequency in Acute Coronary Syndrome Patients with   Varying Hematocrit Levels. Pak Armed Forces Med J [Internet]. 2025 Nov. 29 [cited 2025 Dec. 6];75(SUPPL-7):S1105-S1109. Available from: https://www.pafmj.org/PAFMJ/article/view/13615