Threshold Haemoglobin Levels and the Prognosis of Stable Coronary Disease: Two New Cohorts and a Systematic Review and Meta-Analysis
2011

Threshold Hemoglobin Levels and Mortality in Coronary Disease

Sample size: 34102 publication 10 minutes Evidence: high

Author Information

Author(s): Anoop D. Shah, Nicholas Owen, Adam D. Timmis, Gene Feder, Keith R. Abrams, Ruoling Chen, Aroon D. Hingorani, Harry Hemingway

Primary Institution: University College London

Hypothesis

Is there a threshold hemoglobin level below which mortality increases in patients with stable coronary disease?

Conclusion

Low hemoglobin concentration is associated with increased mortality in patients with stable coronary disease.

Supporting Evidence

  • 29.5% of men with myocardial infarction had hemoglobin below the threshold and had a hazard ratio for mortality of 2.00.
  • Women had a lower threshold hemoglobin value than men, but the risk association was similar.
  • Patients with stable angina and hemoglobin less than 11 g/dl had a higher mortality rate.

Takeaway

If your blood has too little hemoglobin, it can make you more likely to get very sick or die if you have heart problems.

Methodology

A retrospective cohort study using the UK General Practice Research Database and a systematic review and meta-analysis of previous studies.

Potential Biases

Potential residual confounding and missing data may introduce bias.

Limitations

The study is observational and cannot conclude a causal relationship between hemoglobin concentration and mortality.

Participant Demographics

Patients aged 35 to 90 with stable angina or first myocardial infarction.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 11.5–13.5 for women and 95% CI 13.0–13.4 for men

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000439

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication