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Published on: June 12, 2021
Impacts of anemia on 3-year ischemic events in patients undergoing percutaneous coronary intervention: a
Xiaoyan Wang1, Miaohan Qiu1, Jing Li1
11 Graduate School, Dalian Medical University, Dalian 116044, China ; 2 Department of Cardiology, General Hospital of Shenyang Military Region, Shenyang 110016, China.
Insights
Anemia independently predicts worse outcomes after percutaneous coronary intervention (PCI). Anemic patients face higher risks of 3-year ischemic events, mortality, and major adverse cardiac events (MACE).
Area of Science:
- Cardiology
- Hematology
- Clinical Research
Background:
- Anemia is linked to adverse outcomes in patients undergoing percutaneous coronary intervention (PCI).
- The impact of anemia on long-term ischemic events post-PCI remains unclear.
- Improving anemia management may enhance PCI patient outcomes.
Purpose of the Study:
- To investigate the association between anemia and long-term ischemic events after PCI.
- To evaluate anemia's predictive value for 3-year mortality and major adverse cardiac events (MACE) post-PCI.
Main Methods:
- Analysis of 8,825 patients undergoing PCI, with 581 identified as anemic.
- Propensity score matching used to compare anemic and non-anemic patient groups.
- Primary endpoint: 3-year ischemic events; secondary endpoints: 3-year mortality and MACE.
Main Results:
- Anemic patients were more likely female, older, and had lower left ventricular ejection fraction (LVEF) and creatinine clearance (Ccr).
- Anemia independently predicted 3-year ischemic events (HR: 2.20), mortality (HR: 3.58), and MACE (HR: 2.14) post-PCI.
- Incidence of 3-year ischemic events was 41.0% in anemic vs. 19.3% in non-anemic patients.
Conclusions:
- Anemia is a significant independent predictor of adverse outcomes, including ischemic events, mortality, and MACE, within 3 years post-PCI.
- Further research is warranted to explore anemia's pathogenesis, prevention, and therapeutic strategies in PCI patients.
Background:
Anemia correlates with worse outcomes in patients undergoing percutaneous coronary intervention (PCI), improved anemia can improve the outcomes in patients who underwent PCI. But the influence of anemia on long-term ischemic events after PCI remains unknown.
Methods:
We analyzed 8,825 consecutive patients who underwent PCI at General Hospital of Shenyang Military Region and identified 581 patients with anemia. Patients (anemia vs. no anemia) were compared using a propensity score analysis to best match between groups. The main outcome of this study is 3-year ischemic events after PCI, the secondary outcome of this study is 3-year mortality and major adverse cardiac events (MACE) after PCI.
Results:
Compared with nonanemic patients, anemic patients were often female (38.90% vs. 14.51%) and elder patients (66.44% vs. 34.95%). Anemic patients have lower left ventricular ejection fraction (LVEF) and creatinine clearance (Ccr) and were more likely to have history of cardiovascular and cerebrovascular diseases, hypertension, peripheral vascular diseases (PVD) (P<0.05). However, the prevalences of diabetes and hyperlipidemia were lower in anemic patients (P<0.01). Anemia was an independent predictor for 3-year ischemic events [hazard ratio (HR): 2.20, 95% confidence intervals (CI): 1.61-3.00, P<0.01], 3-year mortality (HR: 3.58, 95% CI: 1.75-7.32, P<0.01) and 3-year MACE (HR: 2.14, 95% CI: 1.64-2.79, P<0.01) after PCI in post-match samples. The incidence of 3-year ischemic events was 41.0% and 19.3% in anemic and nonanemic patients, respectively.
Conclusions:
Anemia is an independent predictor for 3-year ischemic events, 3-year mortality and 3-year MACE in patients who underwent PCI. Further studies need to explore the impact of the pathogenesis and progress, prevention and therapy of anemia on the outcome of patients undergoing PCI.
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