The clinical significance of hematocrit values before and after percutaneous coronary intervention

Area of Science:

• Cardiology
• Hematology
• Interventional Cardiology

Background:

• Anemia before or after percutaneous coronary intervention (PCI) is linked to increased mortality and morbidity.
• Definitions of severe anemia vary, complicating risk assessment.
• The continuous impact of baseline hematocrit and post-PCI hematocrit drop on PCI outcomes remains underexplored.

Purpose of the Study:

• To investigate the independent predictive value of baseline hematocrit and hematocrit drop after PCI as continuous variables.
• To assess their role in the risk stratification of patients undergoing PCI.

Main Methods:

• Analysis of 6,025 consecutive patients undergoing PCI between 2003 and 2007.
• Multivariable Cox regression analysis was used to evaluate hematocrit at baseline and hematocrit drop as continuous variables.
• The primary endpoint was a composite of death and myocardial infarction at 1-year follow-up.

Main Results:

• A continuous increase in the 1-year composite endpoint (death/myocardial infarction) was observed with decreasing baseline hematocrit and/or increasing hematocrit drop post-PCI.
• Both lower baseline hematocrit (HR=0.92, P<.001) and greater hematocrit drop (HR=1.11, P<.001) were significant independent predictors of the primary endpoint after multivariable adjustment.

Conclusions:

• Baseline hematocrit and post-PCI hematocrit drop are significant risk factors for adverse outcomes following PCI.
• Incorporating hematocrit or hemoglobin values as continuous variables into risk-stratification models for PCI patients is recommended.