Soh Rodney Yu-Hang, Sia Ching-Hui, Djohan Andie Hartanto, Lau Rui-Huai, Ho Pei-Ying, Neo Jonathan Wen-Hui, Ho Jamie Sin-Ying, Sim Hui-Wen, Yeo Tiong-Cheng, Tan Huay-Cheem, Chan Mark Yan-Yee, Loh Joshua Ping-Yun
Department of Cardiology, National University Heart Centre, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore.
Front Cardiovasc Med. 2022 Mar 18;9:687555. doi: 10.3389/fcvm.2022.687555. eCollection 2022.
This study aimed to investigate the impact of anaemia on long-term clinical outcomes in patients who underwent semi-urgent and elective percutaneous coronary intervention (PCI) in an Asian population. Although the effects of anaemia on outcomes in Asian patients are well studied for acute coronary syndrome, its impact on Asian patients undergoing semi-urgent and elective PCI is unclear.
This was a retrospective cohort study of patients who underwent semi-urgent and elective PCI from January 1, 2014, to December 31, 2015, at a tertiary academic centre. A total of 1,685 patients were included. They were stratified into three groups: normal (≥12 g/dL), intermediate (10-11.9 g/dL), and low (<10 g/dL) haemoglobin levels. Demographics, risk factors, and end-points including the 5-point major adverse cardiac and cerebrovascular events (MACCE) (all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation), cardiovascular death, and bleeding events were analysed.
Patients in intermediate and low haemoglobin level groups were older with more comorbidities. Compared to the normal haemoglobin level group, low haemoglobin level group patients were associated with an increased risk of composite endpoints of all-cause death, subsequent stroke, myocardial infarction, congestive cardiac failure, and target lesion revascularisation [adjusted hazard ratio (aHR) 1.89, 95% confidence interval (CI):1.22, 2.92; = 0.004]. This was driven by the increased risk of target lesions revascularisation observed in the low haemoglobin level group compared to the normal haemoglobin level group (aHR 17.74, 95% CI: 1.74, 180.80; = 0.015). The patients in the low haemoglobin level group were also associated with a higher risk of bleeding events compared to the normal haemoglobin level group (aHR 7.18, 95% CI: 1.13, 45.40; = 0.036).
In our Asian cohort, patients with anaemia undergoing PCI were associated with a higher comorbid burden. Despite adjustments for comorbidities, these patients had higher mortality and worse cardiovascular outcomes following contemporary PCI.
本研究旨在调查贫血对亚洲人群中接受半紧急和择期经皮冠状动脉介入治疗（PCI）患者长期临床结局的影响。虽然贫血对亚洲急性冠状动脉综合征患者结局的影响已得到充分研究，但其对接受半紧急和择期PCI的亚洲患者的影响尚不清楚。
这是一项对2014年1月1日至2015年12月31日在一家三级学术中心接受半紧急和择期PCI患者的回顾性队列研究。共纳入1685例患者。他们被分为三组：血红蛋白水平正常（≥12 g/dL）、中等（10 - 11.9 g/dL）和低（<10 g/dL）。分析了人口统计学、危险因素和终点，包括5分主要不良心脑血管事件（MACCE）（全因死亡、随后的中风、心肌梗死、充血性心力衰竭和靶病变血运重建）、心血管死亡和出血事件。
血红蛋白水平中等和低的组患者年龄更大，合并症更多。与血红蛋白水平正常组相比，血红蛋白水平低的组患者全因死亡、随后的中风、心肌梗死、充血性心力衰竭和靶病变血运重建的复合终点风险增加[调整后风险比（aHR）1.89，95%置信区间（CI）：1.22，2.92；P = 0.004]。这是由血红蛋白水平低的组与血红蛋白水平正常组相比观察到的靶病变血运重建风险增加所驱动的（aHR 17.74，95% CI：1.74，180.80；P = 0.015）。与血红蛋白水平正常组相比，血红蛋白水平低的组患者出血事件风险也更高（aHR 7.18，95% CI：1.13，45.40；P = 0.036）。
在我们的亚洲队列中，接受PCI的贫血患者合并症负担更高。尽管对合并症进行了调整，但这些患者在当代PCI后死亡率更高，心血管结局更差。
