Abstract
The objective was to assess the impact of baseline anemia on all-cause mortality and whether 12-month dual antiplatelet therapy (DAPT) affects 1-year mortality linked to anemia in patients after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 4109 enrolled patients divided into three groups based on their pre-procedural hemoglobin (Hb) level: Hb < 100 mg/L represented moderate-severe anemia; 100 mg/L ≤ Hb < 120 mg/L for women and 100 mg/L ≤ Hb < 130 mg/L for men represented mild anemia; Hb ≥ 120 mg/L for women and Hb≥130 mg/L for men represented no anemia. DAPT medications were prescribed when patients were discharged. There were significant differences in 30-day and 1-year mortality between moderate-severe anemia and no anemia patients (HR 8.05, 95% CI 1.46 to 44.33, P = 0.017; HR 3.93, 95% CI 1.11 to 13.98, P = 0.034), and in long-term mortality between anemia and no anemia groups (HR 1.82, 95% CI 1.17 to 2.83, P = 0.008 for mild anemia; HR 3.19,95% CI 1.29 to 7.86, P = 0.012 for moderate-severe anemia). There was not significant interaction between 12-month DAPT and anemia on mortality in anemic patients (P for interaction > 0.05). Anemia shows association with increased all-cause mortality in patients undergoing PCI. Twelve-month DAPT does not show synergy with anemia to increase the risk of all-cause 1-year mortality in anemic patients after PCI.
Highlights
Has repeatedly been stressed in the drug-eluting stents (DES) era due to the risk of late stent thrombosis
Has repeatedly been stressed in the DES era due to the risk of late stent thrombosis. It is controversial whether the use of dual antiplatelet therapy (DAPT) after DES increases the mortality of percutaneous coronary intervention (PCI) linked with anemia
Of the 4186 patients with CAD undergoing initial PCI in four hospitals, 4109 (98.2%) patients with baseline hemoglobin were included in the study, 3511 (85.4%) patients finished follow-up, and 598 (14.6%) patients were lost to follow-up because we could not make contact with them
Summary
Study population.We retrospectively analyzed 4109 patients with coronary artery disease who underwent initial PCI with DES at four hospitals in China (Peking University People’s Hospital, Beijing; Beijing University of Chinese Medicine Dongzhimen Hospital, Beijing; Cangzhou Central Hospital, Cangzhou, Hebei Province; Luoyang Central Hospital, Luoyang, Henan Province) from January 1st, 2006 to June 30th, 2011.Demographics, clinical characteristics, angiographic data and hospital outcome data were derived from hospital charts. We retrospectively analyzed 4109 patients with coronary artery disease who underwent initial PCI with DES at four hospitals in China (Peking University People’s Hospital, Beijing; Beijing University of Chinese Medicine Dongzhimen Hospital, Beijing; Cangzhou Central Hospital, Cangzhou, Hebei Province; Luoyang Central Hospital, Luoyang, Henan Province) from January 1st, 2006 to June 30th, 2011. According to criteria of the World Health Organization (WHO)[7], anemia is defined as a hemoglobin concentration of
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