Critical Endpoints In Dynamic Follow-Up Of Anemia Patients With Percutaneous Coronary Intervention For Acute Coronary Syndrome

Abstract

Introduction — Identifying critical endpoints during long-term follow-up of patients with coronary artery disease (CAD) and anemia after percutaneous coronary intervention (PCI) would allow optimizing management tactics for this group of patients. Objective — To investigate the risks of developing adverse cardiovascular complications in patients with anemia who underwent revascularization for acute coronary syndrome (ACS) and to assess the most significant factors affecting outcomes. Material and Methods — The study included 298 patients with CAD who had undergone PCI at least two years before enrollment. A survey of patients and a retrospective analysis of their medical records were conducted. The outcome was a composite endpoint (death, myocardial infarction, stroke, transient ischemic attack). Kaplan-Meier curves were constructed to assess the effect of anemia on outcomes. To identify predictors of an adverse outcome, a Cox regression model was built. Results — In the group of patients with ACS who underwent PCI, the incidence of anemia was 8.4%. The incidence of the composite endpoint in patients with anemia was 51.6%, which was significantly different from its value in patients without anemia after 400 days of follow-up (logrank test, p<0.008). After day 1,200, both groups exhibited similar dynamics of adverse outcomes. The following factors were statistically significantly linked to the risk of death within 24 months after PCI: left ventricular ejection fraction (p=0.002), anemia (p=0.009), and chronic kidney disease (p=0.02). Conclusion — We demonstrated that anemia influenced the development of adverse outcomes from day 400 to day 1,200 of a follow-up. Some factors, such as left ventricular ejection fraction and the presence of chronic kidney disease, also had a high predictive power for adverse events.