Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Wang, Huili; Yang, Yuan; Ma, Lina; Xian, Wang; Zhang, Jun; Fu, Jing; Zhang, Shouyan; Zhang, Ling; Hu, Dayi; Ding, Rongjing

doi:10.1038/srep17213

Cited by 8 publications

(4 citation statements)

References 43 publications

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“…In the current study, there was statistically significant difference in the incidence of arrhythmia in anaemic patients (61.8%) that documented during follow up of patients in hospital was higher as compared with nonanaemic patients (31.5%) (p<0.001). This was matched with Wang et al, 2015a [14] who showed that incidence of reperfusion arrhythmia that was indicator for successful revascularization is higher in patients with anaemia than patients without anaemia.…”

Section: Resultssupporting

confidence: 79%

Short Term Outcome of Percutaneous Coronary Intervention in Anaemic Patients Presenting with Coronary Artery Diseases

Saiyed

Nassar²,

Gendy³

et al. 2023

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Background: Percutaneous coronary intervention (PCI) has been an effective and widely used treatment for patients with coronary artery disease (CAD). The presence of anaemia in critically ill patients undergoing surgical procedures has been associated with worse clinical outcomes. Hence, the current study was conducted to assess short term outcome of percutaneous coronary interventions in anaemic patients presenting with coronary artery diseases. Methods: This prospective observational study enrolled 200 patients who underwent PCI. Patients were classified into 2 groups: anaemic patients and non-anaemic patients. The anaemic patients were furtherly be classified according to severity of anaemia into 3 grades mild anaemia, moderate anaemia, and severe anaemia. All cases were subjected to complete history taking, clinical examination and baseline laboratory tests: including CBC, serum urea and creatinine, cardiac enzymes include serum troponin, CK-MB and standard 12-lead ECG. Results: The mean Heart Rate was statistically significantly higher in the anaemic group as compared with the non-anaemic group. The mean Ejection Fraction was statistically significantly lower in the anaemic group as compared with the non-anaemic group. The percentage of LM affection in the anaemic group was statistically significantly higher as compared with the non-anaemic group. The incidence of arrythmia in the anaemic group was statistically significantly higher as compared with the non-anaemic group. Severe anaemic and low EF% patients were associated with higher incidence of stroke and MI. Conclusions: Patients with baseline anaemia before PCI have a higher incidence of PCI associated complications. Therefore, anaemia could be a predictor of PCI related complications.

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Section: Resultssupporting

confidence: 79%

Short Term Outcome of Percutaneous Coronary Intervention in Anaemic Patients Presenting with Coronary Artery Diseases

Saiyed

Nassar²,

Gendy³

et al. 2023

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“…Yazji et al analyzed 1,731 patients with ACS and found that the duration of antiplatelet therapy in anemic patients was significantly shorter than that in non‐anemic patients (7.8 ± 4.3 vs. 11.2 ± 2.4 months, p < .001) 4 . Moreover, interruption or disruption of DAPT seems to more often occur in patients with anemia, which was demonstrated to be associated with higher risks of all‐cause mortality, MACE, and spontaneous MI, nevertheless 15,16 . In the present study, we found extended DAPT beyond 12 months was associated with reduced risk of ischemic events without increasing the bleeding risk.…”

Section: Discussionsupporting

confidence: 55%

Impact of extended dual antiplatelet therapy on long‐term prognosis in patients with acute coronary syndrome complicated with anemia: A sub‐analysis of the real‐world OPT‐CAD study

Jiang

et al. 2021

Cathet Cardio Intervent

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Objectives To evaluate the impact of extended dual antiplatelet therapy (DAPT) beyond 12 months on long‐term prognosis in acute coronary syndrome (ACS) patients complicated with anemia undergoing percutaneous coronary intervention (PCI). Background Anemia is frequent among ACS patients and is associated with increased risk of adverse clinical outcomes. Methods A total of 6,953 patients were enrolled from the Optimal anti Platelet Therapy for Chinese patients with Coronary Artery Disease (OPT‐CAD) study. A landmark analysis comparing extended DAPT versus single antiplatelet therapy (SAPT) at 12–24 months were performed in anemia patients without premature discontinuation of DAPT before 9 months and major clinical adverse events within 12 months. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), defined as a composite of all‐cause death, myocardial infarction, and stroke. Results Patients with anemia (n = 1,728) had higher rates of MACCE, all‐cause mortality, and BARC type 2, 3, 5 bleeding (p < .05) compared to those without anemia (n = 5,225). Anemia patients received extended DAPT (n = 1,010) were associated with a lower risk of stroke (0.3% vs. 1.8%; HR, 0.14; 95% CI, 0.03–0.71; p = .018) compared to those received SAPT (n = 342). The rates of MACCE and all revascularization were lower in patients with extended DAPT, but the differences were not statistically significant. Risk of all‐cause mortality and bleeding were comparable between the two groups. Conclusions Extended DAPT beyond 12 months may reduce the incidence of stroke without increasing the risk of bleeding in anemic ACS patients who tolerate 12‐month DAPT.

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“…In addition, as Reincke et al [25] suggested, low in-hospital mortality in the PCI group might be explained by the lower hemodynamic stress and shorter myocardial ischemia compared to those who underwent bypass surgery. Moreover, most patients in our PCI cohort had mild to moderate anemia rather than severe anemia, which, as demonstrated by other studies, is associated with a lower mortality rate compared to severe anemia [31]. Another possible explanation is the lower rate of comorbid conditions which increase bleeding risk (CHF, Afib, CKD) in anemic patients who underwent PCI compared to the non-anemic group.…”

Section: Discussionmentioning

confidence: 57%

Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry

Daoulah¹,

Naser²,

Hersi³

et al. 2023

Cardiology

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Introduction: Evaluate the effects of baseline anemia and anemia following revascularization on outcomes in patients with Unprotected Left Main Coronary Artery (ULMCA) disease. Methods: This was a retrospective, multicenter, observational study conducted between January 2015 to December 2019. The data on patients with ULMCA who underwent revascularization through PCI or CABG was stratified by hemoglobin level at baseline into anemic and non-anemic groups to compare in-hospital events. The pre-discharge hemoglobin following revascularization was categorized into very low (<80 g/L for men & women), low (≥80 & ≤119 g/L for women & ≤129 g/L for men) and normal (≥130 g/L for men & ≥120 g/L for women) to assess impact on follow-up outcomes. Results: A total of 2138 patients were included, 796 (37.2%) of which had anemia at baseline. A total of 319 developed anemia after revascularization and moved from being non-anemic at baseline to anemic at discharge. There was no difference in hospital MACE and mortality between CABG and PCI in anemic patients. At a median follow-up time of 20 months (IQR: 27), patients with pre-discharge anemia who underwent PCI had higher incidence of congestive heart failure (P< 0.0001), and those who underwent CABG had significantly higher follow-up mortality (HR: 9.85 (95% CI: 2.53- 38.43), P= 0.001). Discussion/Conclusion: In this Gulf LM study, baseline anemia had no impact upon in-hospital MACCE and total mortality following revascularization (PCI or CABG). However, pre-discharge anemia is associated with worse outcomes after unprotected LMCA disease revascularization, with significantly higher all-cause mortality in patients who had CABG, and higher incidence of CHF in PCI patients, at a median follow-up time of 20 months (IQR: 27).

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Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Cited by 8 publications

References 43 publications

Short Term Outcome of Percutaneous Coronary Intervention in Anaemic Patients Presenting with Coronary Artery Diseases

Short Term Outcome of Percutaneous Coronary Intervention in Anaemic Patients Presenting with Coronary Artery Diseases

Impact of extended dual antiplatelet therapy on long‐term prognosis in patients with acute coronary syndrome complicated with anemia: A sub‐analysis of the real‐world OPT‐CAD study

Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry

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