Jonik Szymon, Skrobucha Alicja, Huczek Zenon, Kochman Janusz, Opolski Grzegorz, Grabowski Marcin, Mazurek Tomasz
1 Department of Cardiology, Medical University of Warsaw, Poland.
Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):393-400. doi: 10.5114/aic.2024.144778. Epub 2024 Nov 5.
Coronary artery disease (CAD) remains one of the major problems of contemporary medicine. Hematological disorders seem to play an important role in progression and severity of CAD. The aging of the population results in an increase in the number of patients with both CAD and anemia.
To assess the impact of anemia on clinical outcomes in patients with multivessel CAD who underwent percutaneous coronary intervention (PCI) in long-term follow-up.
In this retrospective study we examined 6-year outcomes of 679 individuals with multivessel CAD treated with PCI based on the hemoglobin (HGB) value before the interventional procedure. We classified the participants into two groups: anemia and non-anemia. The primary endpoint was overall mortality. Secondary endpoints were major adverse cardiac or cerebrovascular events (MACCE) (i.e. overall mortality, stroke, myocardial infarction (MI), or repeat revascularization (RR)) and separate components of MACCE.
We found that 35.4% (240 out of 679) of the patients were anemic. The occurrence of the primary endpoint significantly differed between anemia and non-anemia-groups (48/240 (20.0%) vs. 51/439 (11.6%), = 0.003). The co-existence of anemia was associated with increased rates of MACCE, MI and in-hospital mortality (177/240 (73.8%) vs. 211/439 (48.1%); 51/240 (21.3%) vs. 44/439 (10.0%) and 21/240 (8.8%) vs. 4/439 (0.9%) for non-anemia, < 0.001 for all, respectively).
Our research identified an important risk factor for stratifying PCI patients. Given the high incidence of anemia in CAD patients undergoing PCI, HGB levels should be assessed upon admission and factored into risk stratification.
冠状动脉疾病（CAD）仍然是当代医学的主要问题之一。血液系统疾病似乎在CAD的进展和严重程度中起重要作用。人口老龄化导致CAD和贫血患者数量增加。
评估贫血对接受经皮冠状动脉介入治疗（PCI）的多支血管CAD患者长期随访临床结局的影响。
在这项回顾性研究中，我们根据介入手术前的血红蛋白（HGB）值，检查了679例接受PCI治疗的多支血管CAD患者的6年结局。我们将参与者分为两组：贫血组和非贫血组。主要终点是全因死亡率。次要终点是主要不良心脏或脑血管事件（MACCE）（即全因死亡率、中风、心肌梗死（MI）或再次血运重建（RR））以及MACCE的各个组成部分。
我们发现35.4%（679例中的240例）的患者患有贫血。贫血组和非贫血组的主要终点发生率有显著差异（48/240（20.0%）对51/439（11.6%），P = 0.003）。贫血的并存与MACCE、MI和住院死亡率的发生率增加相关（非贫血组分别为177/240（73.8%）对211/439（48.1%）；51/240（21.3%）对44/439（10.0%）和21/240（8.8%）对4/439（0.9%），所有P均<0.001）。
我们的研究确定了PCI患者分层的一个重要危险因素。鉴于接受PCI的CAD患者贫血发生率较高，入院时应评估HGB水平并将其纳入风险分层。
