Association between serum hemoglobin and major cardiovascular adverse event in Chinese patients with ST‐segment elevation myocardial infarction after percutaneous coronary intervention

Abstract

Background ST‐segment elevation myocardial infarction (STEMI) is a common clinical acute and severe disease, and it is of great significance to evaluate the prognosis of these patients. Hemoglobin levels are associated with a variety of diseases, but studies on Chinese patients with STEMI after percutaneous coronary intervention (PCI) have not been sufficient. Methods This was a secondary analysis based on a prospective cohort study of patients undergoing PCI in Taizhou, Zhejiang, China. We performed multivariable logistic regression to explore the association between the serum hemoglobin and the incidence of major cardiovascular adverse event (MACE) in patients after PCI. We also used a generalized additive model and smooth curve fitting to explain the nonlinear relationship after adjusting the potential confounders. Finally, the heterogeneity among specific groups was examined by subgroup analysis. Results Of all 462 patients enrolled in this study, 118 (25.54%) developed MACE. There was a negative correlation between serum hemoglobin and MACE in all three models (hazard ratio [HR] 0.82, 95% confidence interval [CI 0.72, 0.93], HR 0.86, 95% CI [0.76,0.98], and HR 0.87, 95% CI [0.74,0.98], respectively). In the subgroup analysis, the negative correlation existed between the patients who had myocardial infarction (MI) history (p for interaction = 0.0059) after adjusting covariates. However, no significant differences were found between age and sex groups (p for interaction = 0.1381, 0.4103, respectively). Conclusion Our results indicated that patients who received PCI with low preoperative hemoglobin were more likely to develop MACE, especially if they have already had a history of MI.

Rosuvastatin plus ticagrelor decreases the risk of major adverse cardiovascular events and elevates cardiac function compared with ticagrelor alone in patients undergoing percutaneous coronary intervention: A meta‑analysis

“…Previous studies have reported that the incidence of MACE is 10.9-30.5% if there is no related treatment among patients receiving PCI (23)(24)(25). Several therapies are recommended to prevent the incidence of MACE during the perioperative period of PCI according to the American College of Cardiology/AHA guidelines, among which statins serve a crucial role (26,27).…”

Factors Associated With Hospital Mortality in Acute Myocardial Infarction

“…Доказано, что риск MACE при ОИМ возрастает в 1,45 раз (95 % ДИ: 1,33-1,58) на каждый 1 г / дл снижения гемоглобина ниже 11 г / дл [27]. Пациенты с ИМпST, перенесшие ЧКВ, с низким уровнем гемоглобина до операции, были более склонны к развитию MACE, особенно если у них уже был ОИМ в анамнезе [28]. На данный момент отсутствуют валидированные рекомендации для инициации гемотрансфузии при ОИМ.…”