Hemoglobin level is an independent predictor of mortality in patients undergoing percutaneous coronary artery interventions

Abstract

Background: Anemia is a powerful predictor of mortality in patients with congestive heart failure. The significance of anemia in patients with coronary artery disease is unknown. Methods: We studied 4309 patients undergoing percutaneous coronary intervention (PCI) from October 1996 to August 2001 stratified by their pre-procedural hemoglobin levels into quartiles. There were 1051 patients in 1 St quartile (mean lib 10.80, range 6.7. 12.0g/dl), 1077 in 2”d quartile (mean Hb 12.75 g/dl, range 12.1.13.39/dl), 1135 in the 3” quartile (mean Hb 13.93 gldl, range 13.4-14.5 g/dl), and 1046 patients in the 4’“quartile (mean Hb15.37 g/dl, range 14.6-18.0 g/dl). Patients were followed for a median of 3 years after the PCI. Results: There were 228 (22%) deaths in the 1 J’quactile, 116 (11%) deaths in the 2ti quartile, 75 (7%) deaths in the 9 quartile, and 61 (6%) deaths in the 4’h quartile. An increase of 1 gmJdl in pre-procedural Hb level was associated with a significant reduction in hazard rate of death after PCI (hazard ratio 0.70, 95%CI 0.67 to 0.74, p<O.OOl). The association remained strong after adjusting for age, gender, white blood cell count, serum creatinine, left ventricular ejection fraction, acute myocardial infarction, diabetes, ACC lesion score, adjunct medications and site of lesion (HR 0.841. 95% Cl 0.79 0.89, p ~0.001) Conclusion: A lower pre-procedural Hb level, even in the range considered to be normal. is associated with increased long-term mortality in patients undergoing PCI.