Wang Huili, Yang Yuan, Ma Lufeng, Wang Xian, Zhang Jun, Fu Jinguo, Zhang Shouyan, Zhang Ling, Hu Dayi, Ding Rongjing
School of Public Health, Capital Medical University, Beijing, China.
School of General Practice and Continuing Education, Capital Medical University, Beijing, China.
Sci Rep. 2015 Nov 25;5:17213. doi: 10.1038/srep17213.
The objective was to assess the impact of baseline anemia on all-cause mortality and whether 12-month dual antiplatelet therapy (DAPT) affects 1-year mortality linked to anemia in patients after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 4109 enrolled patients divided into three groups based on their pre-procedural hemoglobin (Hb) level: Hb < 100 mg/L represented moderate-severe anemia; 100 mg/L ≤ Hb < 120 mg/L for women and 100 mg/L ≤ Hb < 130 mg/L for men represented mild anemia; Hb ≥ 20 mg/L for women and Hb ≥ 130 mg/L for men represented no anemia. DAPT medications were prescribed when patients were discharged. There were significant differences in 30-day and 1-year mortality between moderate-severe anemia and no anemia patients (HR 8.05, 95% CI 1.46 to 44.33, P = 0.017; HR 3.93, 95% CI 1.11 to 13.98, P = 0.034), and in long-term mortality between anemia and no anemia groups (HR 1.82, 95% CI 1.17 to 2.83, P = 0.008 for mild anemia; HR 3.19,95% CI 1.29 to 7.86, P = 0.012 for moderate-severe anemia). There was not significant interaction between 12-month DAPT and anemia on mortality in anemic patients (P for interaction > 0.05). Anemia shows association with increased all-cause mortality in patients undergoing PCI. Twelve-month DAPT does not show synergy with anemia to increase the risk of all-cause 1-year mortality in anemic patients after PCI.
目的是评估基线贫血对全因死亡率的影响，以及12个月的双联抗血小板治疗（DAPT）是否会影响接受药物洗脱支架（DES）经皮冠状动脉介入治疗（PCI）患者中与贫血相关的1年死亡率。4109名入组患者根据术前血红蛋白（Hb）水平分为三组：Hb < 100 mg/L代表中重度贫血；女性100 mg/L ≤ Hb < 120 mg/L且男性100 mg/L ≤ Hb < 130 mg/L代表轻度贫血；女性Hb ≥ 120 mg/L且男性Hb ≥ 130 mg/L代表无贫血。患者出院时开具DAPT药物。中重度贫血患者与无贫血患者在30天和1年死亡率方面存在显著差异（HR 8.05，95%CI 1.46至44.33，P = 0.017；HR 3.93，95%CI 1.11至13.98，P = 0.034），贫血组与无贫血组在长期死亡率方面也存在显著差异（轻度贫血HR 1.82，95%CI 1.17至2.83，P = 0.008；中重度贫血HR 3.19，95%CI 1.29至7.86，P = 0.012）。12个月的DAPT与贫血对贫血患者死亡率的影响之间不存在显著交互作用（交互作用P>0.05）。贫血与接受PCI患者的全因死亡率增加相关。12个月的DAPT在PCI后贫血患者中未显示出与贫血协同增加全因1年死亡率的风险。
