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Five-year outcomes in patients with anemia on admission undergoing a coronary intervention for acute myocardial infarction in Koreans

propensity score matching analysis

Park, Ji Younga,*; Choi, Byoung Geolb,*; Rha, Seung-Woonc; Kang, Tae Sood

doi: 10.1097/MCA.0000000000000657
Myocardial Infarction

Background Acute myocardial infarction (AMI) is a progressive disease in Korea and active treatment strategies can improve the clinical outcomes. In the CADILLAC trial, anemia on admission was associated strongly with adverse outcomes and increased mortality in AMI. However, it remains controversial whether anemia on admission is an independent poor prognostic factor of long-term clinical outcomes in AMI patients undergoing a percutaneous coronary intervention with a drug-eluting stent in Koreans.

Patients and methods A total of 1143 AMI patients undergoing percutaneous coronary intervention with drug-eluting stent at Korea University Guro Hospital between 2005 and 2015 were enrolled. Anemia on admission was defined as hemoglobin levels of less than 13 g/dl in men and less than 12 g/dl in women using the WHO’s criteria. Patients were divided into two groups (472 patients with anemia and 671 patients without anemia). The primary endpoint was major adverse cardiac events (MACE) up to 5 years including death, myocardial infarction, and revascularization.

Results To adjust for confounding factors, we carried out a propensity score matching analysis. Two matched groups (300 pairs, n=600 patients) were generated and their baseline characteristics were balanced. During the 5-year clinical follow-up, patients with anemia had a higher incidence of MI [hazard ratio (HR): 2.137, 95% confidence interval (CI): 1.074–4.254], target vessel revascularization (HR: 1.641, 95% CI: 1.004–2.682), and total MACE (HR: 1.427, 95% CI: 1.012–2.614).

Conclusion AMI patients with anemia on admission had higher incidence of MI, target vessel revascularization, and total MACE over the 5-year follow-up.

aDepartment of Internal Medicine, Division of Cardiology, Eulji Hospital, Eulji University

bDepartment of Internal Medicine, Korea University Graduate School

cDepartment of Internal Medicine, Division of Cardiology, Korea University Guro Hospital, Seoul

dDepartment of Internal Medicine, Division of Cardiology, Dankook University Hospital, Cheonan, Korea

*Ji Young Park and Byoung Geol Choi contributed equally to the writing of this article.

Correspondence to Seung-Woon Rha, MD, PhD, Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82 226 263 020; fax: +82 28 643 062; e-mail: swrha617@yahoo.co.kr

Received March 20, 2018

Accepted June 28, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.