BLOOD HEMOGLOBIN AND THE LONG-TERM INCIDENCE OF ACUTE MYOCARDIAL-INFARCTION AFTER TRANSURETHRAL RESECTION OF THE PROSTATE

Objectives: To study risk factors for acute myocardial infarction (AMI ) in men suffering from benign prostatic hypertrophy. Methods: We foll owed 811 patients who underwent transurethral resection of the prostat e (TURF) between 1983 and 1992 until the end of 1993 with regard to th e incidence of AMI. The association between AMI and various potential risk factors was evaluated by epidemiological methods. Results: Fifty- two patients developed a first-time AMI after TURF. ii pre-operative b lood haemoglobin concentration in the range of 100-129 g/l(normal rang e 130-165 dl) was associated with an increased long-term relative risk of a first-time AMI, which was estimated to be 2.0 (95% confidence in terval = 1.0-4.1), This estimate became slightly stronger when we also included the 76 patients with a first AMI before surgery, 10 of whom developed a re-infarction after TURF. Furthermore, it was largely unch anged on adjusting for impaired health status and age greater than or equal to 75 years (patient factors) and for fluid absorption greater t han or equal to 500 mi and a blood loss greater than or equal to 275 m i (operative factors), which had been reported to increase the longter m risk of AMI in a previous study. Conclusion: A moderately reduced bl ood haemoglobin level before TURF is associated with a doubled risk of developing AMI in later life.