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Hemoglobin, frailty and long-term cardiovascular events in community-dwelling older men aged ≥70 years

Canadian Journal of Cardiology Feb 01, 2022

Among community-dwelling older men, low hemoglobin was found to be linked with increased major adverse cardiovascular events (MACE), independent of frailty. Long-term MACE was shown to be predicted by a hemoglobin cut-point of 140g/L, a level that is above contemporary definitions of anemia.

  • Anemia has been reported to be linked with elevated risk of all-cause death in older populations.

  • In this prospective study (CHAMP: Concord-Health-and-Ageing-in-Men-Project), a total of 1,604 men (mean [±SD] age: 76.9±5.5yrs) were included to examine the link between hemoglobin and MACE and if the association is modulated by frailty.

  • Increased comorbidity, frailty and MACE were found in relation to decreasing hemoglobin, with the optimal cut-point for predicting MACE being 140g/L.

  • Independent predictors of MACE included hemoglobin, age, and frailty.

  • Each 10g/L decrease in hemoglobin concentration was found to be linked with elevated risk of MACE (HR 1.13), all-cause mortality (HR 1.20), cardiovascular mortality (HR 1.07), myocardial infarction (HR 1.17) and heart failure (HR 1.17).

  • On stratification into hemoglobin quintiles, an increased risk of MACE, cardiovascular mortality, myocardial infarction and heart failure was observed in men in the lowest two quintiles (Hb 133-140g/L & <132g/L, respectively).

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