Prognostic impact of anemia on the mortality of United Arab Emirates nationals with cardiovascular disease

Saif Al-Shamsi; Ghada S M Al-Bluwi; Maitha Al Shamsi; Nouf Al Kaabi; Sara Al Khemeiri; Noura Baniyas

doi:10.5339/qmj.2022.3

Prognostic impact of anemia on the mortality of United Arab Emirates nationals with cardiovascular disease

Qatar Med J. 2022 Mar 12;2022(1):3. doi: 10.5339/qmj.2022.3. eCollection 2022.

Authors

Saif Al-Shamsi¹, Ghada S M Al-Bluwi¹, Maitha Al Shamsi¹, Nouf Al Kaabi¹, Sara Al Khemeiri¹, Noura Baniyas¹

Affiliation

¹ Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates E-mail: salshamsi@uaeu.ac.ae.

Abstract

Background: Cardiovascular disease is the leading cause of death worldwide. Multiple risk factors, including low hemoglobin levels, have been associated with poor outcomes in patients with cardiovascular disease. However, the long-term impact of anemia on death has not been investigated in high-risk patients in the United Arab Emirates. Therefore, this study evaluated whether anemia is a significant predictor of mortality in United Arab Emirates nationals with cardiovascular disease over 10 years.

Methods: A retrospective cohort study was conducted in an adult population of United Arab Emirates nationals with a history of cardiovascular disease, recruited from a tertiary healthcare facility. Electronic medical records between April 2008 and December 2008 were reviewed, and follow-up was conducted until December 2019. The survival functions for all-cause mortality in the presence and absence of anemia were compared using univariate Kaplan-Meier analysis with a log-rank test. The association between anemia and all-cause mortality was evaluated using a multivariable Cox regression model.

Results: A total of 224 patients were included in the follow-up for 10.5 years. At baseline, 46% of the patients had anemia, with a mean Hgb level of 105.5 ± 28.0 g/L. Patients with anemia were older (68 vs. 63 years, p = 0.001) and had a higher rate of chronic kidney disease (37.5% vs. 17.5%, p = 0.001) than those without anemia. A total of 77 (34.4%) deaths were recorded by the end of the follow-up period. Risk of all-cause mortality was significantly higher in patients with anemia than in those without (hazard ratio = 2.03, 95% confidence interval = 1.22-3.40, p = 0.006). Age and chronic kidney disease were also statistically significant predictors of death (p < 0.001 and p = 0.001, respectively).

Conclusion: Anemia is an independent predictor of all-cause mortality in United Arab Emirates nationals with underlying cardiovascular disease. Early intervention and treatment for anemia may improve clinical outcomes in this population.

Keywords: Anemia; United Arab Emirates; cardiovascular disease; mortality.