Jiang Lin, Gao Zhan, Song Ying, Xu Jingjing, Tang Xiaofang, Wang Huanhuan, Liu Ru, Jiang Ping, Xu Bo, Yuan Jinqing
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Interv Cardiol. 2018 Dec;31(6):826-833. doi: 10.1111/joic.12570. Epub 2018 Nov 22.
To investigate the impact of anemia on 2-year outcomes in patients undergoing contemporary percutaneous coronary intervention (PCI).
Whether anemia is an independent predictor of adverse outcomes after PCI is under debate.
A total of 10 717 consecutive patients who underwent PCI with available hemoglobin values at Fuwai Hospital were collected. Clinical outcomes were compared between patients with and without anemia both before and after PCI procedure.
Totally, 1348 (12.5%) and 3111 (29.0%) patients presented with pre- and post-PCI anemia according to World Health Organization criteria (hemoglobin level <120 g/L for women or <130 g/L for men), respectively. Anemic patients presented with more baseline clinical risks and more extensive coronary disease than those without anemia. During 2-year follow-up, patients with pre-PCI anemia had higher incidence of bleeding and stroke than those without pre-PCI anemia. Patients with post-PCI anemia experienced higher incidence of all-cause death, myocardial infarction (MI), target vessel revascularization (TVR), bleeding, and major adverse cardiovascular events (MACE) than those without post-PCI anemia. Survival analyses were performed using multivariable Cox proportional hazards models both before and after propensity score matching. Pre-PCI anemia was not an independent risk factor of any adverse clinical events. Post-PCI anemia was not an independent risk factor of all-cause death, but was an independent risk factor of MI, TVR, and MACE.
Pre-PCI anemia was not an independent risk factor of any adverse clinical events, while post-PCI anemia had a predictable value of MI, TVR, and MACE after PCI.
探讨贫血对接受当代经皮冠状动脉介入治疗（PCI）患者2年预后的影响。
贫血是否为PCI术后不良预后的独立预测因素仍存在争议。
收集在阜外医院接受PCI且有血红蛋白值的10717例连续患者。比较PCI术前和术后贫血患者与非贫血患者的临床结局。
根据世界卫生组织标准（女性血红蛋白水平<120 g/L或男性<130 g/L），分别有1348例（12.5%）和3111例（29.0%）患者存在PCI术前和术后贫血。贫血患者比非贫血患者具有更多的基线临床风险和更广泛的冠状动脉疾病。在2年随访期间，PCI术前贫血患者的出血和卒中发生率高于无PCI术前贫血的患者。PCI术后贫血患者的全因死亡、心肌梗死（MI）、靶血管血运重建（TVR）、出血和主要不良心血管事件（MACE）发生率高于无PCI术后贫血的患者。在倾向评分匹配前后均使用多变量Cox比例风险模型进行生存分析。PCI术前贫血不是任何不良临床事件的独立危险因素。PCI术后贫血不是全因死亡的独立危险因素，但却是MI、TVR和MACE的独立危险因素。
PCI术前贫血不是任何不良临床事件的独立危险因素，而PCI术后贫血对PCI术后的MI、TVR和MACE具有预测价值。
