In-hospital prognostic value of hemoglobin levels on admission in patients with acute ST segment elevation myocardial infarction undergoing primary angioplasty

Dündar, Cihan; Oduncu, Vecih; Erkol, Ayhan; Tanalp, Ali Cevat; Sırma, Dicle; Karagöz, Ali; Karabay, Can Yücel; Kılıçgedik, Alev; Pala, Selçuk; Tigen, Kürşat; Izgi, Akin; Kırma, Cevat

doi:10.1007/s00392-011-0361-9

Cited by 31 publications

(32 citation statements)

References 27 publications

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“…Kaplan-Meier event-free survival curves in the current study revealed that most of the thrombotic as well as bleeding events occurred early (within 30 days) following the index PCI (figure 1). This finding is in line with previous reports 6 8 9 15. In patients with coronary artery disease, anaemia may aggravate myocardial ischaemia and unveil significant coronary obstruction.…”

Section: Discussionsupporting

confidence: 93%

“…However, the results of the current study support the previous reports on the increased bleeding risk associated with anaemia in various patient groups undergoing PCI 8 9 19. Anaemia may be a marker and consequence of an underlying condition such as bleeding diathesis, occult gastrointestinal bleeding or malignancy that augments the bleeding risk.…”

Section: Discussionsupporting

confidence: 89%

“…Anaemic patients undergoing PCI are generally older, with more comorbidities, and have higher rates of in-hospital mortality and major adverse cardiac and cerebrovascular events (MACCE), as well as 1-year mortality 6 7. Furthermore, low admission haemoglobin level was found to be an independent predictor of in-hospital and long-term mortality, and was associated with higher rates of in-hospital minor and major bleeding events in patients undergoing primary PCI for ST-segment elevation myocardial infarction (MI) 8 9…”

Section: Introductionmentioning

confidence: 99%

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Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry

et al. 2014

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ObjectivesAnaemia has an adverse impact on the outcome in the general patient population undergoing percutaneous coronary intervention (PCI). The aim of this study was to analyse the impact of anaemia on the 12-month clinical outcome of patients with atrial fibrillation (AF) undergoing PCI and therefore requiring intense antithrombotic treatment. We hypothesised that anaemia might be associated with a worse outcome and more bleeding in these anticoagulated patients.SettingData were collected from 17 secondary care centres in Europe.ParticipantsConsecutive patients with AF undergoing PCI were enrolled in the prospective, multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. Altogether, 929 patients participated in the study. Preprocedural haemoglobin concentration was available for 861 (92.7%; 30% women). The only exclusion criteria were inability or unwillingness to give informed consent. Anaemia was defined as a haemoglobin concentration of <12 g/dL for women and <13 g/dL for men.Outcome measuresThe primary endpoint was occurrence of major adverse cardiac and cerebrovascular events (MACCE) or bleeding events.Results258/861 (30%) patients had anaemia. Anaemic patients were older, more often had diabetes, higher CHA2DS2-VASc scores, prior history of heart failure, chronic renal impairment and acute coronary syndrome. Anaemic patients had more MACCE than non-anaemic (29.1% vs 19.4%, respectively, p=0.002), and minor bleeding events (7.0% vs 3.3%, respectively, p=0.028), with a trend towards more total bleeding events (25.2% vs 21.7%, respectively, p=0.059). No difference was observed in antithrombotic regimens at discharge. In multivariate analysis, anaemia was an independent predictor of all-cause mortality at 12-month follow-up (hazard ratio 1.62, 95% CI 1.05 to 2.51, p=0.029).ConclusionsAnaemia was a frequent finding in patients with AF referred for PCI. Anaemic patients had a higher all-cause mortality, more thrombotic events and minor bleeding events. Anaemia seems to be an identification of patients at risk for cardiovascular events and death.Trial registrationClinicalTrials.gov number NCT00596570.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry

et al. 2014

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“…13 It is well known that patients with an eGFR < 60 mL/min/1.73 m 2 are more likely to have anemia and that prevalence and severity of anemia increase with declining renal function. 23 Our study demonstrated, however, that baseline hemoglobin level was an independent risk factor for AKI in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Anemia is a common finding known to have a detrimental effect on the outcome of STEMI. [11][12][13] Previous studies have shown that anemia increases the risk of contrast-induced nephropathy (CIN) in patients who undergo computed tomography and non-emergent percutaneous coronary intervention. [14][15][16] As far as the authors know there are no previous reports that have specifically addressed a selective subset of STEMI patients who undergo PPCI in whom preprocedural preparatory measures to reduce AKI are often underused because of the need for emergent reperfusion therapy.…”

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confidence: 99%

Association of Admission Hemoglobin Levels and Acute Kidney Injury Among Myocardial Infarction Patients Treated With Primary Percutaneous Intervention

Shacham

Gal‐Oz

Leshem

et al. 2015

Canadian Journal of Cardiology

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Prognostic implication of hemoglobin reduction with and without clinical bleeding after percutaneous coronary intervention in patients with acute coronary syndromes

Aladin,

Wermers,

Zhang

et al. 2023

Cathet Cardio Intervent

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BackgroundBleeding events are associated with higher mortality rates in patients with cardiovascular diseases, including patients presenting with acute coronary syndrome (ACS) undergoing coronary revascularization. We aimed to determine whether a reduction in hemoglobin (Hgb) from pre‐ to postpercutaneous coronary intervention (PCI), with or without evidence of clinical bleeding, is a correlate of in‐hospital mortality for patients presenting with ACS who underwent primary PCI.MethodsWe divided 33816 consecutive patients with ACS who underwent PCI into three categories: (1) target group (defined as Hgb reduction without overt bleeding [n = 112]); (2) Hgb reduction with overt bleeding (n = 48); and (3) control group (defined as no Hgb reduction and no overt bleeding [n = 3156]). Hgb reduction was defined as a drop of >3 g/dL in Hgb value from preprocedure and postprocedure during the index hospitalization. The primary outcome was in‐hospital mortality. We used logistic regression to examine the relationship between Hgb reduction with and without bleeding and in‐hospital mortality.ResultsIn crude analysis, the Hgb reduction with overt bleed group had a higher in‐hospital mortality rate (16.7%) than the target (9.8%) and control groups (0.6%). Adjusted logistic regression estimates a 0.393 (95% confidence interval [CI]: 0.137, 1.869) odds ratio for in‐hospital death of the target group over the Hgb reduction with bleed group, and a 54.517 (95% CI: 2.07, >1000) odds ratio of the target group over the control group.ConclusionsIn patients presenting with ACS undergoing PCI, Hgb reduction with and without overt bleeding were both independently associated with in‐hospital mortality.

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In-hospital prognostic value of hemoglobin levels on admission in patients with acute ST segment elevation myocardial infarction undergoing primary angioplasty

Abstract: Lower concentrations of Hb on admission are associated with higher rates of in-hospital mortality, heart failure and major bleeding after p-PCI.

Cited by 31 publications

References 27 publications

Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry

Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry

Association of Admission Hemoglobin Levels and Acute Kidney Injury Among Myocardial Infarction Patients Treated With Primary Percutaneous Intervention

Prognostic implication of hemoglobin reduction with and without clinical bleeding after percutaneous coronary intervention in patients with acute coronary syndromes

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