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Title Clinical Characteristics and Outcomes of Patients with Differing Haemoglobin Levels Undergoing Semi-Urgent and Elective Percutaneous Coronary Intervention |
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Type Free Paper Session 4 |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Invasive Diagnostic & Interventional Cardiology |
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Main Author Rui Huai Lau1 |
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Presenting Author Rui Huai Lau1 |
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Co-Author Ching Hui Sia2 Pei Ying Ho1 Tiong Cheng Yeo1 2 Huay Cheem Tan1 2 Mark Yan Yee Chan1 2 Joshua Ping Yun Loh1 2 |
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Department / Institution / Country Yong Loo Lin School of Medicine / National University of Singapore / Singapore1 Department of Cardiology / National University Heart Centre, Singapore / Singapore2 |
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Objective(s) Anemia is an adverse predictor in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). The influence of anemia in patients undergoing semi-urgent and elective PCI remains unknown. This study aims to characterize the impact of differing hemoglobin levels on clinical outcomes of such patients. |
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Material and Method We performed a retrospective database study of patients who underwent semi-urgent and elective PCI from January 2014 to December 2015 at a tertiary academic centre. Patients were followed-up until December 2018. The patients were stratified into 3 groups – low (L) (Hb <10g/dL), intermediate (I) (Hb 10 - 11.9g/dL), normal (N) (Hb ³12g/dL) haemoglobin. Demographics, risk factors and end-points (time-to-event analysis) including subsequent stroke/transient ischemic attack (TIA), myocardial infarction (MI), congestive cardiac failure (CCF) and all-cause mortality were analyzed. |
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Result(s) Of the 1684 patients studied, there were 83(4.9%), 225(13.4%) and 1376(81.7%) patients with low, intermediate and normal hemoglobin respectively. Low and intermediate hemoglobin patients were older (L:65.3 ± 14.3 vs I:66.7 ± 11.1 vs N:59.9 ± 10.8years) with higher proportion of females (L:54.2% vs I:44.0% vs N:13.7%, p<0.001) and co-morbid burden of hypertension, dyslipidemia, diabetes and peripheral vascular disease. In terms of outcomes, low hemoglobin patients were twice as likely to develop subsequent stroke/TIA(L:6.0% vs N:3.1%, p<0.001) and MI(L:9.6% vs N:5.4%, p<0.001) and thrice as likely to develop subsequent CCF(L:12.0% vs N:4.7%, p<0.001). Number of all-cause and cardiac-related mortality was almost 5-fold higher(33.7% vs 6.9%, p<0.001) and 7-fold higher(16.9% vs 2.5%, p<0.001) respectively in low compared to normal hemoglobin patients. Multivariate survival analysis showed that low hemoglobin patients were associated with increased all-cause mortality [adjusted HR:2.51 (95% CI 1.39-4.53)]. |
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Conclusion Patients with lower haemoglobin levels who underwent semi-urgent and elective PCI had a higher co-morbidity burden and greater all-cause mortality compared to patients with normal haemoglobin levels. Further studies are required to examine this association. |