Abstract 17163: Comparison of First and Second-generation Drug-eluting Stents in Patients Presenting With Anemia
Background: Presence of anemia is associated with an increased risk of death, myocardial infarction (MI) and bleeding complications after PCI in particular particularly in acute coronary syndromes (ACS).
Aim of this all-comer registry was to compare first and second-generation drug-eluting stents (DES) in patients with coronary artery disease (CAD) presenting with anemia in 1-year follow-up.
Methods: We enrolled 1485 consecutive patients [Stable CAD, n=455 (30,6%); unstable angina, n=716 (48,2%); STEMI, n=91 (6,2%); NSTEMI, n=223 (15%)] treated either with first (paclitaxel, sirolimus) or second generation (everolimus, zotarolimus, biolimus A9) DES (o-DES=170; n-DES=1315). Anemia was defined according to WHO [hemoglobin (Hb) level <13g/dL for men and <12g/dL for women]. Incidence of MACCE (death, MI, stroke, repeat-revascularization) at 1-year was a primary end-point of this study.
Results: The study population was stratified according to presence of anemia on admission: anemia (+) (n = 173, 11%) and no anemia (n = 1312, 89%). Patients with anemia were older (67±10 vs. 62±10 years, p<0.001), had higher prevalence of co-morbidities: diabetes (20% vs. 13% p=0.01), COPD (10% vs. 5% p=0.02), PAD (17% vs. 11% p=0.02), higher creatinine (p<0.01) and lower LVEF values (p<0.01). No difference between gender in frequency of anemia was found. Patients with anemia had more often prior myocardial infarction (57% vs. 49%, p=0.03) and CABG (34% vs. 21%, p= 0,0002) in comparison to patients without anemia. They also had more often multi vessel disease in angiography (33% vs. 25% p=0,02). However, there were no differences in complexity of CAD (as measured by SYNTAX [SX] score). Despite higher disease burden in patients with anemia 1-year follow up showed that there was no difference in MACCE (death, MI, stroke, repeat-revascularization) in comparison to patients with normal Hb (p=0,60). There was also no difference according to type of DES (first vs. new generation).
Conclusion: Presence of anemia does not increase 1-year incidence of MACCE in patients treated with first- and second-generation DES in all-comer population of patient with stable CAD and ACS.
- © 2013 by American Heart Association, Inc.