Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.
Clin Res Cardiol. 2012 Jan;101(1):37-44. doi: 10.1007/s00392-011-0361-9. Epub 2011 Sep 20.
Anemia is a common comorbidity in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the in-hospital prognostic value of admission hemoglobin (Hb) levels in patients with acute STEMI undergoing primary percutaneous coronary intervention (p-PCI).
This is a retrospective study of 1,625 patients with STEMI stratified by quartiles of admission Hb concentration (Q1 ≤12.5 g/dl, Q2 12.6-13.8 g/dl, Q3 13.9-15.0 g/dl, Q4 ≥15.1 g/dl). Main outcome measures were in-hospital rates of all cause mortality, re-infarction, target vessel revascularization, stroke, heart failure (HF) and bleeding complications.
The incidences of in-hospital mortality according to quartiles from Q1 to Q4 were 8.6, 3.9, 2.4 and 2.6%, respectively (p < 0.001). The incidences of major hemorrhage and HF were significantly higher in Q1, compared to the other quartiles (7.4, 1.9, 3.1, 2.8%, p < 0.001; 16.3, 8.5, 7.7, 9.8%, p < 0.001, respectively). Multiple logistic-regression analysis showed that low admission Hb level (Q1) is an independent and a potent predictor for in-hospital mortality [unadjusted odds ratio (OR): 3.84, 95% confidence interval (CI): 1.78-7.82; p < 0.001].
Lower concentrations of Hb on admission are associated with higher rates of in-hospital mortality, heart failure and major bleeding after p-PCI.
贫血是 ST 段抬高型心肌梗死（STEMI）患者的常见合并症。本研究旨在探讨行直接经皮冠状动脉介入治疗（p-PCI）的急性 STEMI 患者入院时血红蛋白（Hb）水平对住院期间预后的影响。
这是一项回顾性研究，共纳入 1625 例 STEMI 患者，根据入院时 Hb 浓度的四分位区间进行分层（Q1≤12.5g/dl、Q2 12.6-13.8g/dl、Q3 13.9-15.0g/dl、Q4≥15.1g/dl）。主要观察终点为住院期间全因死亡率、再梗死、靶血管血运重建、卒中和心力衰竭（HF）及出血并发症的发生率。
根据 Q1 到 Q4 的四分位区间，住院期间死亡率分别为 8.6%、3.9%、2.4%和 2.6%（p<0.001）。与其他三分位区间相比，Q1 组的大出血和 HF 发生率显著升高（7.4%、1.9%、3.1%、2.8%，p<0.001；16.3%、8.5%、7.7%、9.8%，p<0.001）。多因素 logistic 回归分析显示，入院 Hb 水平较低（Q1）是住院期间死亡率的独立且强预测因素[未校正比值比（OR）：3.84，95%置信区间（CI）：1.78-7.82；p<0.001]。
p-PCI 后入院时 Hb 浓度较低与住院期间死亡率、HF 和大出血发生率升高相关。
