Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry

Abstract

Introduction: Evaluate the effects of baseline anemia and anemia following revascularization on outcomes in patients with Unprotected Left Main Coronary Artery (ULMCA) disease. Methods: This was a retrospective, multicenter, observational study conducted between January 2015 to December 2019. The data on patients with ULMCA who underwent revascularization through PCI or CABG was stratified by hemoglobin level at baseline into anemic and non-anemic groups to compare in-hospital events. The pre-discharge hemoglobin following revascularization was categorized into very low (<80 g/L for men & women), low (≥80 & ≤119 g/L for women & ≤129 g/L for men) and normal (≥130 g/L for men & ≥120 g/L for women) to assess impact on follow-up outcomes. Results: A total of 2138 patients were included, 796 (37.2%) of which had anemia at baseline. A total of 319 developed anemia after revascularization and moved from being non-anemic at baseline to anemic at discharge. There was no difference in hospital MACE and mortality between CABG and PCI in anemic patients. At a median follow-up time of 20 months (IQR: 27), patients with pre-discharge anemia who underwent PCI had higher incidence of congestive heart failure (P< 0.0001), and those who underwent CABG had significantly higher follow-up mortality (HR: 9.85 (95% CI: 2.53- 38.43), P= 0.001). Discussion/Conclusion: In this Gulf LM study, baseline anemia had no impact upon in-hospital MACCE and total mortality following revascularization (PCI or CABG). However, pre-discharge anemia is associated with worse outcomes after unprotected LMCA disease revascularization, with significantly higher all-cause mortality in patients who had CABG, and higher incidence of CHF in PCI patients, at a median follow-up time of 20 months (IQR: 27).

Single Versus Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting for Unprotected Left-Main Coronary Disease

“…The study is from The Gulf Left-Main registry database. [9][10][11][12][13][14] The study included patients who had CABG for unprotected left-main disease, were discharged on either single or DAPT, and had a follow-up of at least 6 months. Patients with protected left-main disease, hospital mortality, concomitant valve or aortic surgery, previous revascularization for LMCA disease, and patients who had follow-up for less than 6 months were excluded from the analysis.…”