Adverse effects have been reported in patients with preprocedural anemia after percutaneous
coronary intervention (PCI), but data regarding the relation between elevated hemoglobin
(Hb) level and post-PCI prognosis remain limited. This study assessed the impact of
elevated Hb on major adverse cardiac and cerebrovascular event (MACCE) at 12 months,
a composite of all-cause mortality, nonfatal myocardial infarction, and ischemic stroke
after PCI. We pooled patient-level data from four Korean multicenter drug-eluting
stent registries from 2010 to 2016. In total, 5,107 patients were divided into 5 categories
according to the baseline Hb level (<10, 10 to 12.9, 13 to 14.9, 15 to 16.9 and ≥17
g/dl). Patients with higher Hb levels were significantly younger, predominantly male,
current smokers with higher body mass index, and more frequent dyslipidemia. Hypertension,
diabetes, chronic kidney disease, and cerebrovascular accident were more prevalent
in lower Hb groups. Categorically, a U-shaped curvilinear relation was observed between
baseline Hb and clinical outcomes showing significantly higher MACCE rate in <10g/dl
(hazard ratio [HR], 4.62 [2.81 to 7.68]) and ≥17 g/dl (HR, 4.06 [1.57 to 10.5]) groups
compared with the reference group (13 to 14.9 g/dl), especially in men. In nonanemic
patients (Hb ≥13 g/dl), adjusted HRs of MACCE, mortality, and stroke were significantly
higher in ≥17 g/dl group than in the reference group. Furthermore, ≥17 g/dl was an
independent predictor for MACCE and all-cause mortality after PCI. In conclusion,
not only low Hb but also elevated Hb of ≥17 g/dl was significantly associated with
higher MACCE rates and all-cause mortality after PCI. An appropriate treatment strategy
for patients with high Hb level should be identified through future studies.
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Article info
Publication history
Published online: August 09, 2019
Accepted:
July 26,
2019
Received in revised form:
July 25,
2019
Received:
March 23,
2019
Footnotes
Funding: This study was financially supported by the “Lee Kyu-Suk” Faculty Research Assistance Program of Yonsei University College of Medicine for 2014 (6-2014-0192).
Identification
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© 2019 Elsevier Inc. All rights reserved.
