Anemia is an independent indicator of mortality in patients with acute myocardial infarctions

(AMIs). Although anemia may be a transient phenomenon, secondary to acute blood

loss, the prevalence and clinical significance of anemia after recovery from AMI are not

known. In this study, 1,065 patients with AMIs for whom postdischarge hemoglobin levels

were available were assessed. Patients were categorized into 4 groups according to their

anemia status at hospital discharge and at follow-up (no anemia, resolved anemia, persistent

anemia, and new-onset anemia). The association between anemia and the primary end

point of mortality and hospitalization for heart failure was evaluated using Cox models,

using patients without anemia at the 2 time points as the reference group. At hospital

discharge, anemia was present in 370 patients (34.7%). At follow-up, anemia had resolved

in 162 patients (15.2%), 208 (19.5%) had persistent anemia, and 55 (5.2%) had new-onset

anemia. During the follow-up period (median 27 months) 110 patients (10.3%) died, and 89

(8.4%) developed heart failure. The outcomes of patients with resolving anemia were

similar to those of patients without anemia (hazard ratio 0.8, 95% confidence interval 0.5

to 1.3). In contrast, there was a marked increase in mortality and heart failure in patients

with persistent (hazard ratio 1.8, 95% confidence interval 1.2 to 2.5) and new-onset (hazard

ratio 1.9, 95% confidence interval 1.1 to 3.3) anemia. In conclusion, persistent or new-onset

anemia occurs in a significant proportion of patients after AMI. Whereas the resolution of

anemia after AMI is associated with better outcomes, persistent or new-onset anemia

portends increased risk for heart failure and death. © 2009 Elsevier Inc. All rights

reserved. (Am J Cardiol 2009;104:486–491)