Aim: To evaluate the association between the preprocedural hemoglobin (Hb) level and 1 year major adverse cardiac event (MACE) in patients undergoing percutaneous coronary intervention (PCI).
Methods: A total of 2819 patients (mean age 56.61 ± 10.37 years, 69% male) with available preprocedural Hb levels were included. Patients were followed up for 12 months. MACE included cardiac death, myocardial infarction (MI), target vessel revascularization and target lesion revascularization. MACE was compared across the different levels of Hb in nonanemic, mild, moderate, and severe anemia subgroups.
Results: The preprocedural mean Hb level was 13.56 ± 1.67 g/dl. Anemic patients were older, more frequently women, and less likely to be cigarette smokers compared to the nonanemic group. Patients with Hb less than 10 mg/dl had the highest proportion of renal failure (56.7%) compared to 40.1% in moderate, 34.6% in mild, and 22.7% in nonanemic groups. In-hospital MI and death occurred in 8 (0.3%) and 2 (0.1%) of the nonanemic group, respectively, and 1 (0.3%) patient with mild anemia experienced MI. After 12 months the rate of total MACE was 3.4% in all the patients. After adjustment for age, sex, interaction between sex, and Hb level, smoking, hypertension, diabetes mellitus, and creatinine clearance, only severe anemia with Hb below 10 g/dl was associated with an increased risk of MACE (hazard ratio 4.623; 95% confidence interval 1.642-13.021; P = 0.004).
Conclusion: The impact of anemia on the 12-month MACE was more prominent in patients with Hb below 10 mg/dl. Therefore, in patients with severe anemia listed for PCI, this level of Hb should be considered as a precaution.