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ABS20191029_0005
| Acute Coronary Syndromes (STEMI, NSTE-ACS) | |
| Impact of Anemia on Long-Term Outcomes of Patients with ST-Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention | |
| Lin Jiang1, Yue Liu1, Jinqing Yuan1 | |
| Fuwai Hospital, China1 | |
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Background:
Anemia is an important co-morbidity in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). The effect of baseline anemia on long-term outcomes of such patients have not been well defined.
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Methods:
From January to December 2013, 1447 patients with acute STMEI who underwent PCI at Fuwai Hospital with available baseline hemoglobin data were included. Anemia is defined as hemoglobin in male <130g/L and in female <120g/L. The primary endpoint was all-cause death at 2 years after PCI. The secondary endpoints included cardiac death, hemorrhage and major adverse cardiovascular events (MACE, composite of all-cause death, repeat revascularization and myocardial infarction).
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Results:
A total of 206 patients (14.2%) had anemia at baseline. Compared with patients with normal hemoglobin at admission, patient with anemia were older, had higher proportion of female, higher prevalence of comorbidities such as history of diabetes, hyperlipidemia or stroke and worse cardiac function presented as lower left ventricular ejection fraction (LVEF) and higher NT-pro BNP (all p<0.05). On the other side, patients with anemia had lower body mass index, lower serum lipid level and lower proportion of current smokers (all p<0.05). 1439 (99.4%) completed 2-year follow-up. The all-cause mortality was higher in patients with anemia than that in patients without anemia (4.4% vs 1.8%, p=0.02). There was no statistically significant difference in the incidence of cardiac death, myocardial infarction, repeat revascularization, hemorrhage or MACE between the two groups (all p >0.05). Cox regression analysis found that anemia was not an independent risk factor for all pre-specified endpoints, but the independent risk factors for all-cause death were older age and lower left ventricular ejection fraction (p<0.05).
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Conclusion:
Compared with STEMI patients without anemia, those with anemia had higher baseline clinical risk and higher all-cause mortality during 2-year follow-up, but anemia was not an independent predictor of any adverse events.
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