18 Patients presenting with anaemia undergoing primary PCI appear at significantly higher risk of an adverse outcome. (9th June 2011)

• Record Type: Journal Article
• Authors: Rathod, K R; Jones, D A; Rathod, B; Graham, A; Sammut, E; Gallagher, S; Behar, J; Jain, A K; Knight, C; Mathur, A; Wragg, A; Amersey, R
• Is Part Of: Heart. Volume 97(2011)Supplement 1
• Page Start: A15
• Page End: A15
• Publication Date: 2011-06-09
• Subjects: Anaemia -- STEMI -- transfusion; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2011-300198.18
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Previous studies have demonstrated a relationship between pre-existing anaemia and inpatient mortality after percutaneous coronary intervention (PCI). There is limited data looking at the impact of baseline Haemoglobin and long term outcome after primary PCI. Methods: Clinical information was analysed from a prospective database on 2357 STEMI patients who underwent Primary PCI between January 2004 and May 2010 at a London centre. Information was entered at the time of procedure and outcome assessed by all-cause mortality information provided by the Office of National Statistics via the BCIS/CCAD national audit. Anaemia was defined according to WHO definition of Hb greater than or equal to 12 g/dl for females and 13 g/dl for males. Results: 471 (20%) patients were anaemic at presentation. The anaemic cohort, were older (72.2 vs 62.4, p<0.0001), had higher incidence of diabetes (27% vs 15%, p<0.0001), hypertension (42 vs 35%, p=0.01), hypercholesterolaemia (40 vs 30%, p=0.007), previous PCI (13 vs 7%, p=0.01), and previous MI (23% vs 12%, p<0.0001). There were similar incidences of three-vessel disease and cardiogenic shock. Over a 3-year follow-up period there was significantly higher all cause mortality in the anaemic group compared to the normal Hb group (20.4% vs 13.5%, p<0.0001). See Abstract 18 figure 1 . After adjusting for comorbidities, anaemia remained an independent predictor of long-term adverse outcome (OR=2.4, 95% CI=1.1 to 3.7, p<0.001). Patients with baseline anaemia who received a blood transfusion were significantly more likely to suffer an adverse outcome than those that did not receive a transfusion (21% vs 6%, p<0.0001). Conclusion: Patients presenting with anaemia undergoing primary PCI appear at significantly higher risk of an adverse outcome. This risk increases further in population receiving RBC transfusions during index hospitalisation.