Background: The significance of anemia on admission in patients with acute myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) remains controversial. The aim of this study was to evaluate the effect of anemia on long-term prognosis for 30-days survivors with AMI received drug eluting stent (DES).
Method: A total 1,350 consecutive patients with AMI treated with PCI using DES and survived more than 30 days were enrolled. Anemia was defined using World Health Organization criteria (hemoglobin level <13 g/dl for men and <12 g/dl for women). The study population was divided into 2 major groups (anemia group [n = 231, 17.1%] and control group [n = 1,119, 82.9%]) and several high risk subgroups- old age (>65years), hypertension, diabetes, reduced renal function (estimated glomerular filteration rate < 60ml/min/1.73m2), left ventricular dysfunction (ejection fraction <40%), and multivessel disease. A comparative analysis was performed between both groups within the whole population and within the particular subgroups.
Result: Mean follow up duration was 25 ± 15 months and total 55 (4.1%) deaths were observed. Significantly greater mortality were shown in the anemic group than control group (12.1% vs 2.4%, p<0.001). Multivariate analysis identified anemia as an independent predictor of all cause mortality in the whole population during follow up period (adjusted hazard ratio [aHR] 2.08, 95% confidence interval [CI] 1.09 to 3.94, p = 0.025). Anemia was significantly associated with excessive long-term mortality in the old-age group (aHR 2.06, 95% CI 1.04 to 4.10, p=0.039) the hypertensive group (aHR 2.64, 95% CI 1.16 to 6.05), reduced renal function group (aHR 2.78, 95% CI 1.18 to 6.56, p=0.019) and multivessel disease (aHR 2.17, 95% CI 1.05 to 4.52, p=0.037).
Conclusion: Anemia on admission in 30-day survivors with AMI was still independently associated with increasing long-term mortality in DES era, especially in the subgroups with old age, hypertension, reduced renal function and multivessel disease.
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