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Published on: September 22, 2020
Preoperative hemoglobin predicts clinical outcomes after percutaneous coronary intervention
Hailang Liu1, Chunyang Yu1, Tingting Hu1
1Department of Cardiology, The Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, 1 Huanghe West Road, Huaian, 223300, China.
Insights
Low preoperative hemoglobin levels increase the risk of major adverse cardiac events (MACE) in patients with stable coronary artery disease (SCAD) undergoing percutaneous coronary intervention (PCI). A hemoglobin level below 12.25 g/dl is an optimal threshold for predicting MACE.
Area of Science:
- Cardiology
- Hematology
Background:
- Anemia is linked to increased major adverse cardiac events (MACE) in myocardial infarction patients.
- The predictive value of anemia and preoperative hemoglobin for clinical outcomes in stable coronary artery disease (SCAD) patients undergoing percutaneous coronary intervention (PCI) requires assessment.
Purpose of the Study:
- To evaluate the role of preoperative hemoglobin levels in predicting MACE in SCAD patients receiving PCI.
- To determine the optimal hemoglobin threshold for MACE prediction in this patient cohort.
Main Methods:
- Secondary analysis of a retrospective cohort study involving 204 SCAD patients who underwent PCI.
- Primary outcome: MACE (all-cause mortality, non-fatal myocardial infarction, non-fatal stroke). Secondary outcome: cardiovascular events.
- Multivariate COX regression, ROC curve analysis, and Kaplan-Meier analysis were employed.
Main Results:
- During a median follow-up of 783 days, 28 patients experienced MACE.
- Low hemoglobin level independently predicted worse prognosis for both primary (HR=0.72, p=0.012) and secondary endpoints (HR=0.71, p=0.027) after PCI.
- The optimal hemoglobin threshold for MACE prediction was identified as 12.25 g/dl, with levels below this associated with worse outcomes (p<0.001).
Conclusions:
- Low preoperative hemoglobin levels are associated with an increased risk of MACE in SCAD patients undergoing PCI.
- A preoperative hemoglobin level of 12.25 g/dl serves as an optimal threshold for predicting MACE in this population.
Background:
Concurrent anemia is associated with an increased risk of major adverse cardiac events (MACE) in patients with myocardial infarction. The study aimed to assess the value of anemia and preoperative hemoglobin levels in predicting clinical outcomes in stable coronary artery disease (SCAD) patients receiving percutaneous coronary intervention (PCI).
Methods:
This is a secondary analysis based on a retrospective cohort study in which 204 patients with SCAD who received PCI were recruited. The primary outcome was major adverse cardiac events (MACE; including all-cause mortality, non-fatal myocardial infarction, and non-fatal stroke) and the secondary outcome was cardiovascular events (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke).
Results:
During a median follow-up of 783 days, MACE occurred in 28 patients. In multivariate COX regression analysis, after adjusting for potential confounding factors, low hemoglobin level independently predicted worse prognosis at the primary endpoint (HR = 0.72, 95% CI 0.56 to 0.93, p = 0.012) and the secondary endpoint (HR = 0.71, 95% CI 0.52 to 0.96, p = 0.027) after PCI. The receiver operating characteristic curve (ROC) showed that the best threshold for hemoglobin to predict MACE was 12.25 g/dl. In Kaplan-Meier analysis, hemoglobin < 12.25 g/dl predicted worse prognosis in MACE (p < 0.001).
Conclusions:
Low preoperative hemoglobin level increased the risk of MACE in SCAD patients receiving PCI and the optimal threshold for predicting MACE is 12.25 g/dl.
