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Published on: January 28, 2020
Anemia is an independent predictor of mortality after percutaneous coronary intervention
Paul C Lee1, Annapoorna S Kini, Chowdhury Ahsan
1Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, New York 10029-6574, USA.
Insights
Anemia independently predicts mortality after percutaneous coronary intervention (PCI). Patients with anemia face higher risks of adverse procedural events and poorer midterm survival rates following PCI.
Area of Science:
- Cardiology
- Hematology
- Interventional Cardiology
Background:
- Anemia is linked to increased mortality in heart failure and myocardial infarction (MI) patients.
- Investigating anemia's role in percutaneous coronary intervention (PCI) outcomes is crucial.
Purpose of the Study:
- To determine if anemia serves as a marker for increased procedural risk and reduced midterm survival post-PCI.
- To assess the association between pre-procedural hemoglobin (Hb) levels and patient outcomes.
Main Methods:
- A cohort of 6,116 consecutive PCI patients was analyzed.
- Patients were stratified into three groups based on baseline Hb: severe anemia (Hb <10 g/l), mild anemia (Hb 10-12 g/l), and no anemia (Hb >12 g/l).
Main Results:
- Anemia correlated with increased 30-day major adverse cardiac events (MACE), elevated cardiac biomarkers (troponin, CK-MB), and longer hospital stays.
- Anemic patients showed significantly lower one-year survival rates compared to non-anemic patients (adjusted HR for mild anemia: 1.5; severe anemia: 1.8).
- The negative impact of anemia on survival was consistent across stable angina, unstable angina, and MI presentations.
Conclusions:
- Anemia is an independent predictor of mortality following PCI.
- Anemia is associated with heightened short-term adverse procedural events in PCI patients.
Objectives:
The aim of the present study was to assess whether anemia is a marker of increased risk during interventional procedure and poor midterm survival after percutaneous coronary intervention (PCI).
Background:
Anemia is associated with increased risk of mortality in patients with heart failure and myocardial infarction (MI).
Methods:
We examined the outcomes of 6,116 consecutive PCI patients based on the hemoglobin (Hb) value before the interventional procedure. Patients were divided into three groups based on the baseline Hb level (g/l): Hb <10 = severe anemia; Hb 10 to 12 = mild anemia; Hb >12 = no anemia.
Results:
The presence of anemia is associated with higher 30-day major adverse cardiac events, post-PCI peak troponin and creatine kinase-MB fraction, and a longer length of stay. After controlling for multiple covariates, significant difference in one-year survival was noted in the anemic groups compared with no anemia group (adjusted hazard ratio for Hb 10 to 12: 1.5 [95% confidence interval 1.3 to 1.8]; for Hb <10: 1.8 [95% confidence interval 1.3 to 2.3]; p = 0.004.) This adverse effect of anemia on survival was noted in all three presenting clinical syndromes (stable angina, unstable angina, and MI).
Conclusions:
Anemia is an independent predictor of mortality after PCI and is associated with higher short-term adverse procedural events.
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