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CLINICAL RESEARCH

Anemia is an independent predictor of mortality after percutaneous coronary intervention

^* Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, New York, USA

Manuscript received December 29, 2003; revised manuscript received March 26, 2004, accepted April 13, 2004.

^* Reprint requests and correspondence: Dr. Samin K. Sharma, Mount Sinai Hospital, Box 1030, One Gustave Levy Place, New York, New York 10029-6574, USA.
samin.sharma{at}msnyuhealth.org

Presented at the 52nd Annual Scientific Session of the American College of Cardiology in March 2003.

OBJECTIVES: The aim of the present study was to assess whether anemia is a marker of increased risk during interventional procedure and poor midterm survival after percutaneous coronary intervention (PCI).

BACKGROUND: Anemia is associated with increased risk of mortality in patients with heart failure and myocardial infarction (MI).

METHODS: We examined the outcomes of 6,116 consecutive PCI patients based on the hemoglobin (Hb) value before the interventional procedure. Patients were divided into three groups based on the baseline Hb level (g/l): Hb <10 = severe anemia; Hb 10 to 12 = mild anemia; Hb >12 = no anemia.

RESULTS: The presence of anemia is associated with higher 30-day major adverse cardiac events, post-PCI peak troponin and creatine kinase-MB fraction, and a longer length of stay. After controlling for multiple covariates, significant difference in one-year survival was noted in the anemic groups compared with no anemia group (adjusted hazard ratio for Hb 10 to 12: 1.5 [95% confidence interval 1.3 to 1.8]; for Hb <10: 1.8 [95% confidence interval 1.3 to 2.3]; p = 0.004.) This adverse effect of anemia on survival was noted in all three presenting clinical syndromes (stable angina, unstable angina, and MI).

CONCLUSIONS: Anemia is an independent predictor of mortality after PCI and is associated with higher short-term adverse procedural events.

Abbreviations and Acronyms   CK-MB = creatine kinase-MB fraction   Hb = hemoglobin   LV = left ventricle/ventricular   LVEF = left ventricular ejection fraction   MACE = major adverse cardiac event   MI = myocardial infarction   PCI = percutaneous coronary intervention

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