Abstract
Anaemia and high haemoglobin levels are common in ST elevation myocardial infarction (STEMI) patients, but the effect of the haemoglobin level on the prognosis of STEMI patients remains in dispute. This study aimed to evaluate the prognostic value of the haemoglobin level combined with the CAMI-STEMI score in STEMI patients after percutaneous coronary intervention (PCI). We included 360 STEMI patients who underwent PCI. The patients were divided into 3 groups according to the first haemoglobin value after PCI. Clinical characteristics and the incidence of major adverse cardiovascular and cerebral events (MACCE) during the follow-up period were recorded. The incidence of MACCE in the 3 groups increased with a decrease in the haemoglobin level. Multivariate regression analysis showed that the CAMI-STEMI score was an independent predictor of MACCE incidence at 30 days after PCI and that anaemia was an independent predictor of MACCE incidence at 6 months and 1 year after PCI. A high haemoglobin level was an independent predictor of MACCE incidence at 1 year after PCI. The area under receiver operating characteristic curves (AUCs) of the haemoglobin level, CAMI-STEMI score, and haemoglobin level combined with CAMI-STEMI score predicting the occurrence of MACCE in STEMI patients within 30 days after PCI were 0.604, 0.614, and 0.639, respectively. In conclusion, The CAMI-STEMI score was an independent predictor of MACCE incidence at 30 days after PCI. The haemoglobin level combined with the CAMI-STEMI score improved the predictive value of MACCE in STEMI patients within 30 days after PCI. Trial Registration. This trial was a prospective cohort study and registered with ChiCTR-ROC-17011542.
Highlights
Anaemia and high haemoglobin levels are common in ST elevation myocardial infarction (STEMI) patients, but the effect of the haemoglobin level on the prognosis of STEMI patients remains in dispute [1, 2]
Multivariate regression analysis (Table 4) showed that the CAMI-STEMI score was an independent predictor of major adverse cardiovascular and cerebral events (MACCE) incidence at 30 days after percutaneous coronary intervention (PCI) (HR:1.225; 95%confidence intervals (CIs):1.067-1.406; P=0.004)
TC = total cholesterol; LDL-C = low-density lipoprotein cholesterol; LVEF = left ventricular ejection fraction. ∗The CAMI-STEMI score was an independent predictor of MACCE incidence at 30 days after PCI (HR:1.225; 95%CI:1.067-1.406; P=0.004)
Summary
Anaemia and high haemoglobin levels are common in ST elevation myocardial infarction (STEMI) patients, but the effect of the haemoglobin level on the prognosis of STEMI patients remains in dispute [1, 2]. Numerous observational studies have suggested that anaemia is an independent predictor of short-term cardiovascular events during hospitalization and within 30 days in patients with acute coronary syndrome (ACS) [3,4,5]. There were different views on the role of anaemia in forecasting the long-term prognosis of patients with ACS [6, 7]. The prognostic value of anaemia in patients with different types of myocardial infarction (STEMI and NSTEMI) was not the same [1]. The correlation between elevated haemoglobin levels and cardiovascular risk remains unclear. In patients with ACS, the usefulness of risk score for predicting death and cardiovascular complications has been proved both in the short and long term [1, 8]. Yang et al developed the China Acute Myocardial Infarction registry-ST Elevation
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