Cardiovascular Center, The First Hospital of Jilin University, Changchun 130021, China.
Cardiovasc Ther. 2020 Feb 27;2020:8647837. doi: 10.1155/2020/8647837. eCollection 2020.
Anemia following acute myocardial infarction (AMI) is associated with poor outcomes. While previous studies in patients with AMI have focused on anemia at admission, we hypothesized that hemoglobin (Hb) decline during hospitalization and lower discharge Hb would be associated with greater long-term mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
We analyzed records of 983 STEMI patients who were treated with primary PCI. The primary end point was all-cause mortality at 1 year and 2 years. The relationship between discharge Hb levels, decline in Hb levels, bleeding event classification, and all-cause mortality was determined.
Overall, 16.4% of patients had bleeding events, which were classified by the Thrombolysis in Myocardial Infarction (TIMI) score as 7% minimal, 8.6% minor, and 0.9% major. No significant gastrointestinal bleed and cerebral hemorrhage occurred in hospitals among these patients. The incidence rate of the 2-year all-cause mortality increased with severity of the bleeding event score (8.78% for no bleeding vs. 11.59% for minimal bleeding vs. 20.24% for minor bleeding vs. 55.56% for major bleeding, < 0.001). Discharge Hb was significantly associated with 2-year mortality in an unadjusted model (hazard ratio (HR) per 1 g/L decrease in discharge Hb = 1.020, 95% confidence interval (CI): 1.006-1.034, < 0.001). Discharge Hb was significantly associated with 2-year mortality in an unadjusted model (hazard ratio (HR) per 1 g/L decrease in discharge Hb = 1.020, 95% confidence interval (CI): 1.006-1.034, < 0.001). Discharge Hb was significantly associated with 2-year mortality in an unadjusted model (hazard ratio (HR) per 1 g/L decrease in discharge Hb = 1.020, 95% confidence interval (CI): 1.006-1.034.
In this population of patients hospitalized for STEMI, all-cause mortality increased with lower discharge Hb, and discharge Hb was a significant predictor of mortality risk.
急性心肌梗死（AMI）后贫血与不良预后相关。既往 AMI 患者的研究主要关注入院时的贫血，我们假设 ST 段抬高型心肌梗死（STEMI）患者行直接经皮冠状动脉介入治疗（PCI）时住院期间血红蛋白（Hb）下降和出院时 Hb 较低与长期死亡率增加相关。
我们分析了 983 例 STEMI 患者接受直接 PCI 治疗的记录。主要终点是 1 年和 2 年的全因死亡率。确定出院时 Hb 水平、Hb 下降程度、出血事件分类与全因死亡率之间的关系。
总体而言，16.4%的患者发生出血事件，按心肌梗死溶栓治疗（TIMI）评分分类为 7%轻微、8.6%轻度和 0.9%重度。这些患者在医院未发生明显胃肠道出血和脑出血。2 年全因死亡率随出血事件评分严重程度增加而升高（无出血为 8.78%，轻微出血为 11.59%，轻度出血为 20.24%，重度出血为 55.56%，<0.001）。未校正模型中，出院 Hb 与 2 年死亡率显著相关（每降低 1g/L 出院 Hb，风险比[HR]为 1.020，95%置信区间[CI]：1.006-1.034，<0.001）。未校正模型中，出院 Hb 与 2 年死亡率显著相关（每降低 1g/L 出院 Hb，风险比[HR]为 1.020，95%置信区间[CI]：1.006-1.034，<0.001）。未校正模型中，出院 Hb 与 2 年死亡率显著相关（每降低 1g/L 出院 Hb，风险比[HR]为 1.020，95%置信区间[CI]：1.006-1.034，<0.001）。
在 STEMI 住院患者中，全因死亡率随出院时 Hb 降低而增加，出院时 Hb 是死亡率风险的重要预测因素。
