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Impact of anemia on nonfatal coronary events after percutaneous coronary interventions

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Abstract

Anemia is associated with higher rates of cardiovascular events in patients with heart failure, acute myocardial infarction, and in patients undergoing coronary artery bypass graft surgery. Although studies have focused on fatal coronary events in anemic patients following percutaneous coronary intervention (PCI), data is lacking regarding nonfatal coronary events. The aim of our study was to analyze the incidence of anemia in patients who developed nonfatal events after successful PCI, and to make a comparison with event-free patients. Forty-nine consecutive patients with and 51 without nonfatal coronary events (nonfatal myocardial infarction, coronary artery bypass grafting, or repeat PCI) during the 1-year follow-up after the index PCI procedure were included in the study. Anemia was defined using World Health Organization (WHO) criteria as a hematocrit value at initial presentation <39% for men and <36% for women. Baseline hematocrit levels were measured before the procedure. Baseline clinical, lesion, and procedural characteristics were comparable in both groups. Anemia was present in 33.8% of men and 30.4% of women. The incidence of anemia in patients with nonfatal coronary events was 46.9% and 15.7% in the event-free group, which was significantly different (P = 0.001). Anemia was found to be an independent risk factor for nonfatal coronary events in PCI patients (odds ratio: 2.24, 95% confidence interval: 1.05–4.79; P = 0.036). In conclusion, anemia is an important risk factor for predicting nonfatal coronary events after PCI. Although previous studies have shown its impact on fatal events, this study has demonstrated that anemia also has a role in nonfatal thrombotic coronary events and restenosis.

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References

  1. GR DeFoe CS Ross EM Olmstead SD Surgenor MP Fillinger RC Groom RJ Forest JW Pieroni CS Warren ME Bogosian CF Krumholz C Clark RA Clough PW Weldner SJ Lahey BJ Leavitt CA Marrin DC Charlesworth P Marshall GT O'Connor (2001) ArticleTitleLowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group Ann Thorac Surg 71 769–776 Occurrence Handle11269449 Occurrence Handle10.1016/S0003-4975(00)02393-6 Occurrence Handle1:STN:280:DC%2BD3M7mvVWjug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. JA Ezekowitz FA McAlister PW Armstrong (2003) ArticleTitleAnemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12 065 patients with new-onset heart failure Circulation 107 223–225 Occurrence Handle12538418 Occurrence Handle10.1161/01.CIR.0000052622.51963.FC

    Article  PubMed  Google Scholar 

  3. WC Wu SS Rathore Y Wang MJ Radford HM Krumholz (2001) ArticleTitleBlood transfusion in elderly patients with acute myocardial infarction N Engl J Med 345 1230–1236 Occurrence Handle11680442 Occurrence Handle10.1056/NEJMoa010615 Occurrence Handle1:STN:280:DC%2BD3Mrnt1Gksw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. D Zindrou KM Taylor JP Bagger (2002) ArticleTitlePreoperative haemoglobin concentration and mortality rate after coronary artery bypass surgery Lancet 359 1747–1748 Occurrence Handle12049866 Occurrence Handle10.1016/S0140-6736(02)08614-2 Occurrence Handle1:CAS:528:DC%2BD38XktFKjtrw%3D

    Article  PubMed  CAS  Google Scholar 

  5. SC Smith SuffixJr JT Dove AK Jacobs JW Kennedy D Kereiakes MJ Kern RE Kuntz JJ Popma HV Schaff DO Williams RJ Gibbons JP Alpert KA Eagle DP Faxon V Fuster TJ Gardner G Gregoratos RO Russell SC Smith SuffixJr (2001) ArticleTitleACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines)—executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) J Am Coll Cardiol 37 2215–2239 Occurrence Handle11419905 Occurrence Handle10.1016/S0735-1097(01)01344-4

    Article  PubMed  Google Scholar 

  6. EJ Topol (2003) Elective coronary intervention: approach, technique, and complications EJ Topol (Eds) Textbook of interventional cardiology EditionNumber4th edn Saunders Philadelphia 1123

    Google Scholar 

  7. InstitutionalAuthorNameWHO (1968) Nutritional Anemias. Report of a WHO Scientific Group World Health Organization Geneva

    Google Scholar 

  8. AS Levey JP Bosch JB Lewis T Greene N Rogers D Roth (1999) ArticleTitleA more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group Ann Intern Med 130 461–470 Occurrence Handle10075613 Occurrence Handle1:CAS:528:DyaK1MXitFChs7k%3D

    PubMed  CAS  Google Scholar 

  9. DL Dries DV Exner MJ Domanski B Greenberg LW Stevenson (2000) ArticleTitleThe prognostic implications of renal insufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction J Am Coll Cardiol 35 681–689 Occurrence Handle10716471 Occurrence Handle10.1016/S0735-1097(99)00608-7 Occurrence Handle1:STN:280:DC%2BD3c7nvFaitw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. JL Carson A Duff RM Poses JA Berlin RK Spence R Trout H Noveck BL Strom (1996) ArticleTitleEffect of anaemia and cardiovascular disease on surgical mortality and morbidity Lancet 348 1055–1060 Occurrence Handle8874456 Occurrence Handle10.1016/S0140-6736(96)04330-9 Occurrence Handle1:STN:280:ByiD38fksVc%3D

    Article  PubMed  CAS  Google Scholar 

  11. LS Czer WC Shoemaker (1978) ArticleTitleOptimal hematocrit value in critically ill postoperative patients Surg Gynecol Obstet 147 363–368 Occurrence Handle684587 Occurrence Handle1:STN:280:CSeB2M%2FntVY%3D

    PubMed  CAS  Google Scholar 

  12. PC Hebert G Wells MA Blajchman J Marshall C Martin G Pagliarello M Tweeddale I Schweitzer E Yetisir (1999) ArticleTitleA multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group N Engl J Med 340 409–417 Occurrence Handle9971864 Occurrence Handle10.1056/NEJM199902113400601 Occurrence Handle1:STN:280:DyaK1M7it1Khsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. PC Hebert G Wells M Tweeddale C Martin J Marshall B Pham M Blajchman I Schweitzer G Pagliarello (1997) ArticleTitleDoes transfusion practice affect mortality in critically ill patients? Transfusion Requirements in Critical Care (TRICC) Investigators and the Canadian Critical Care Trials Group Am J Respir Crit Care Med 155 1618–1623 Occurrence Handle9154866 Occurrence Handle1:STN:280:ByiB1MbntFM%3D

    PubMed  CAS  Google Scholar 

  14. TB Horwich GC Fonarow MA Hamilton WR MacLellan J Borenstein (2002) ArticleTitleAnemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure J Am Coll Cardiol 39 1780–1786 Occurrence Handle12039491 Occurrence Handle10.1016/S0735-1097(02)01854-5

    Article  PubMed  Google Scholar 

  15. TR Pedersen J Kjekshus K Berg T Haghfelt O Faergeman G Faergeman K Pyorala T Miettinen L Wilhelmsen AG Olsson H Wedel InstitutionalAuthorNameScandinavian Simvastatin Survival Study Group (1994) ArticleTitleRandomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) Lancet 344 1383–1389 Occurrence Handle10.1016/S0140-6736(94)91755-8

    Article  Google Scholar 

  16. InstitutionalAuthorNameHOPE study investigators (1996) ArticleTitleThe HOPE (Heart Outcomes Prevention Evaluation) Study: the design of a large, simple randomized trial of an angiotensin-converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. The HOPE study investigators Can J Cardiol 12 127–137

    Google Scholar 

  17. J Veselka S Prochazkova R Duchonova I Homolova D Tesar KA Bybee (2006) ArticleTitlePreprocedural statin therapy reduces the risk and extent of cardiac biomarker release following percutaneous coronary intervention Heart Vessels 21 146–151 Occurrence Handle16715188 Occurrence Handle10.1007/s00380-005-0885-x

    Article  PubMed  Google Scholar 

  18. I Watanabe K Nagao S Tani N Masuda T Yahata S Ohguchi K Kanmatsuse T Kushiro (2006) ArticleTitleReperfusion strategy for acute myocardial infarction in elderly patients aged 75 to 80 years Heart Vessels 21 236–241 Occurrence Handle16865299 Occurrence Handle10.1007/s00380-005-0897-6

    Article  PubMed  Google Scholar 

  19. MJ Sarnak H Tighiouart G Manjunath B MacLeod J Griffith D Salem AS Levey (2002) ArticleTitleAnemia as a risk factor for cardiovascular disease in The Atherosclerosis Risk in Communities (ARIC) study J Am Coll Cardiol 40 27–33 Occurrence Handle12103252 Occurrence Handle10.1016/S0735-1097(02)01938-1

    Article  PubMed  Google Scholar 

  20. E Dillmann DG Johnson J Martin B Mackler C Finch (1979) ArticleTitleCatecholamine elevation in iron deficiency Am J Physiol 237 R297–R300 Occurrence Handle495778 Occurrence Handle1:CAS:528:DyaL3cXitV2lsg%3D%3D

    PubMed  CAS  Google Scholar 

  21. M Takahashi S Kurokawa T Tsuyusaki R Kikawada (1990) ArticleTitle[Studies of hyperkinetic circulatory state in chronic anemia] J Cardiol 20 331–339 Occurrence Handle2104408 Occurrence Handle1:STN:280:By6A2svivFQ%3D

    PubMed  CAS  Google Scholar 

  22. TJ McMahon RE Moon BP Luschinger MS Carraway AE Stone BW Stolp AJ Gow JR Pawloski P Watke DJ Singel CA Piantadosi JS Stamler (2002) ArticleTitleNitric oxide in the human respiratory cycle Nat Med 8 711–717 Occurrence Handle12042776 Occurrence Handle1:CAS:528:DC%2BD38XkvFehsLg%3D

    PubMed  CAS  Google Scholar 

  23. JF Mann (1999) ArticleTitleWhat are the short-term and long-term consequences of anaemia in CRF patients? Nephrol Dial Transplant 14 IssueIDSuppl 2 29–36 Occurrence Handle10334665 Occurrence Handle10.1093/ndt/14.suppl_2.29

    Article  PubMed  Google Scholar 

  24. JM Hill G Zalos JP Halcox WH Schenke MA Waclawiw AA Quyyumi T Finkel (2003) ArticleTitleCirculating endothelial progenitor cells, vascular function, and cardiovascular risk N Engl J Med 348 593–600 Occurrence Handle12584367 Occurrence Handle10.1056/NEJMoa022287

    Article  PubMed  Google Scholar 

  25. D Orlic J Kajstura S Chimenti I Jakoniuk SM Anderson B Li J Pickel R McKay B Nadal-Ginard DM Bodine A Leri P Anversa (2001) ArticleTitleBone marrow cells regenerate infarcted myocardium Nature 410 701–705 Occurrence Handle11287958 Occurrence Handle10.1038/35070587 Occurrence Handle1:CAS:528:DC%2BD3MXivFSmsb4%3D

    Article  PubMed  CAS  Google Scholar 

  26. HV Anderson RE Shaw RG Brindis K Hewitt RJ Krone PC Block CR McKay WS Weintraub (2002) ArticleTitleA contemporary overview of percutaneous coronary interventions. The American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR) J Am Coll Cardiol 39 1096–1103 Occurrence Handle11923031 Occurrence Handle10.1016/S0735-1097(02)01733-3

    Article  PubMed  Google Scholar 

  27. DR Holmes F Selzer JM Johnston SF Kelsey R Holubkov HA Cohen DO Williams KM Detre (2003) ArticleTitleModeling and risk prediction in the current era of interventional cardiology: a report from the National Heart, Lung, and Blood Institute Dynamic Registry Circulation 107 1871–1876 Occurrence Handle12668511 Occurrence Handle10.1161/01.CIR.0000065229.72905.78

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Florence Nightingale Hospital, Abide-i Hurriyet Cad. No: 290, 34381 Sisli, Istanbul, Turkey

    Alp Burak Catakoglu, Huseyin Celebi & I.C. Cemsid Demiroglu

  2. Department of Cardiology, Istanbul Bilim University, Florence Nightingale Hospital, Istanbul, Turkey

    Saide Aytekin, Murat Sener, Hilal Kurtoglu & Vedat Aytekin

Authors
  1. Alp Burak Catakoglu
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  2. Saide Aytekin
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  3. Murat Sener
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  4. Hilal Kurtoglu
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  5. Huseyin Celebi
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  6. I.C. Cemsid Demiroglu
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Correspondence to Alp Burak Catakoglu.

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Catakoglu, A., Aytekin, S., Sener, M. et al. Impact of anemia on nonfatal coronary events after percutaneous coronary interventions. Heart Vessels 22, 383–388 (2007). https://doi.org/10.1007/s00380-007-0995-8

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