Abstract 15966: Impact of Sustained Anemia on Long Term Clinical Outcomes in Patients Who Underwent Drug-Eluting Stent
Introduction: Only a few studies presented concerning anemia because of its association with myocardial ischemia, and demonstrated that anemia is an independent predictor of high 30-day major adverse cardiac events (MACEs) and 1-year MACEs after percutaneous coronary intervention (PCI).
Hypothesis: We assessed the hypothesis that anemia during the follow-up period is associated with adverse long term clinical outcomes.
Methods: Anemia was defined by WHO criteria (hemoglobin < 12 g/dL for female and < 13 g/dL for male subjects). Laboratory study was performed at the index drug-eluting stent (DES) implantation and at the outpatient visit between 3months and 12months later. We categorized patients into four groups based on initial and follow-up hemoglobin levels (normal, anemia-corrected, newly developed anemia, sustained anemia groups).
Results: We analyzed consecutive 9292 patients performed PCI with DESs in COACT (Catholic medical center percutaneous Coronary intervention) registry from January, 2004 to December, 2009. Of these, 4721 subjects with initial and follow-up hemoglobin were enrolled in this study and median follow up was 26.8 months (interquatile range 14.4-42.3). After adjusting multiple covariates, newly developed anemia group and sustained anemia group demonstrated a significant increase in a hazard ratio (HR) of a composite of all-cause death, myocardial infarction and stroke (HR=2.382, p<0.001, 95% confidence interval (CI) 1.724 to 3.290; HR=2.471, p<0.001, 95% CI 1.811 to 3.370, respectively) comparing with normal group. There was no significant increase of HR in the anemia group corrected during follow up period (p=0.637, 95% CI 0.689 to 1.837).
Conclusion: Follow-up anemia after PCI is a poor prognostic factor. Concerning MACEs, follow-up anemia is more important than anemia at the index procedure, which should be corrected.
- © 2011 by American Heart Association, Inc.