Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

Abstract

The present investigation, performed in 1,122 consecutive STEMI patients treated with primary coronary intervention, was aimed at evaluating: (1) the prevalence of prior anemia and its prognostic significance in the short term; and (2) the prevalence of new anemia and its impact in the short term. The prevalence of prior anemia was 27.4%. Patients with a prior anemia were older and exhibited a higher incidence of chronic diseases and comorbidities. They showed a higher intra-hospital mortality rate (p \ 0.001), a higher incidence of PCI failure (p \ 0.001) and major bleedings (p \ 0.001). Prior anemia was an independent predictor for intra-hospital mortality (OR 2.12; 95% CI 1.21-3.70, p = 0.009). Patients with a new anemia account for 46.8% of our series, and showed a higher early mortality rate and incidence of major bleedings in respect to those who maintained normal Hb values (p \ 0.05 and \0.05, respectively). our data strengthens the prognostic role of Hb values in STEMI patients submitted to primary PCI, since the presence of prior anemia identified a subset of patients, characterized by advanced age, higher comorbidities and serious coronary artery disease, at higher risk for intra ICCU mortality and complications. Moreover, the development of anemia during an ICCU stay is common, and is associated with a higher mortality rate and incidence of complications in respect to patients who maintain normal Hb values.

Impact of hypertension on short- and long-term prognoses in patients with ST elevation myocardial infarction and without previously known diabetes

“…In our hospital, in Florence, the reperfusion strategy of STEMI patients is represented by primary PCI [14][15][16][17][18][19]. STEMI patients are first evaluated by the Medical Emergency System staff in the prehospital setting and then directly admitted to the catheterization laboratory or transferred to it after rapid stabilization in First Aid.…”

Meta-Analysis of the Prognostic Impact of Anemia in Patients Undergoing Percutaneous Coronary Intervention

“…Current clinical guidelines fail to offer recommendations for its concurrent management in patients undergoing PCI. Patients with anaemia who undergo PCI are frequently older (5-7), with multiple co-morbidities including higher rates of renal failure (1,(8)(9)(10)(11), diabetes (1,8), previous history of myocardial infarction (12,13) and more extensive and complex coronary disease (12)(13)(14). These clinical and procedural characteristics are well known to be associated with poorer outcomes post PCI.…”

Predictors for in-hospital peak glycemia in STEMI patients without previously known diabetes

“…From 30th June 2008 to 30th March 2011, 651 consecutive patients with STEMI [4] without previously known diabetes, were admitted to our Intensive Cardiac Care Unit (ICCU), after primary PCI [3][4][5][6][7][8][9].…”