Anemia at Admission and Clinical Outcomes in Patients With Acute ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Anemia is common in ST-elevation myocardial infarction (STEMI) patients. The influence of anemia on the prognosis of STEMI patients remains unclear. Robust data are lacking regarding the outcome of patients with moderate-to-severe anemia who present with STEMI and who are treated via primary percutaneous coronary intervention (PCI). This study aimed to evaluate the effects of chronic anemia on major adverse cardiovascular and cerebral events (MACCE) in patients with STEMI undergoing primary PCI.

The present study recruited 330 consecutive STEMI patients who underwent primary PCI from November 2017 through October 2019 at our cardiology department. The study population was divided into 2 groups according to the hemoglobin level after primary PCI. The patients’ baseline clinical characteristics and relationships between hemoglobin levels and the incidence of MACCE during a 1-year follow-up were recorded.

Patients with a hemoglobin level of less than 11 g/dL were elderly, had a lower body mass index, a higher incidence rate of diabetes, a higher Killip class at presentation, and a higher incidence rate of MACCE. Anemia at admission was an independent predictor of MACCE during hospitalization and on post-primary PCI follow-ups at 30 days, 6 months, and 1 year after PCI (P=0.034, 0.028, 0.0032, and 0.0042, respectively).

Age, hypertension, and diabetes in STEMI patients with moderate-to-severe anemia were associated with an increased incidence rate of MACCE. Moderate-to-severe anemia at admission was an independent predictor of MACCE during hospitalization and on post-primary PCI follow-ups at 30 days, 6 months, and 1 year.  (Iranian Heart Journal 2021; 22(2): 58-67)