Original Paper

Clinical Research in Cardiology

, Volume 101, Issue 1, pp 37-44

In-hospital prognostic value of hemoglobin levels on admission in patients with acute ST segment elevation myocardial infarction undergoing primary angioplasty

  • Cihan DündarAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Vecih OduncuAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Ayhan ErkolAffiliated withDepartment of Cardiology, Kocaeli Derince Education and Research Hospital Email author 
  • , Ali Cevat TanalpAffiliated withDepartment of Cardiology, Medicana International Hospital
  • , Dicle SırmaAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Ali KaragözAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Can Yücel KarabayAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Alev KılıçgedikAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
  • , Selçuk PalaAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
    • , Kürşat TigenAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
    • , Akın IzgiAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital
    • , Cevat KırmaAffiliated withDepartment of Cardiology, Kosuyolu Heart Education and Research Hospital

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Abstract

Purpose

Anemia is a common comorbidity in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the in-hospital prognostic value of admission hemoglobin (Hb) levels in patients with acute STEMI undergoing primary percutaneous coronary intervention (p-PCI).

Methods

This is a retrospective study of 1,625 patients with STEMI stratified by quartiles of admission Hb concentration (Q1 ≤12.5 g/dl, Q2 12.6–13.8 g/dl, Q3 13.9–15.0 g/dl, Q4 ≥15.1 g/dl). Main outcome measures were in-hospital rates of all cause mortality, re-infarction, target vessel revascularization, stroke, heart failure (HF) and bleeding complications.

Results

The incidences of in-hospital mortality according to quartiles from Q1 to Q4 were 8.6, 3.9, 2.4 and 2.6%, respectively (p < 0.001). The incidences of major hemorrhage and HF were significantly higher in Q1, compared to the other quartiles (7.4, 1.9, 3.1, 2.8%, p < 0.001; 16.3, 8.5, 7.7, 9.8%, p < 0.001, respectively). Multiple logistic-regression analysis showed that low admission Hb level (Q1) is an independent and a potent predictor for in-hospital mortality [unadjusted odds ratio (OR): 3.84, 95% confidence interval (CI): 1.78–7.82; p < 0.001].

Conclusion

Lower concentrations of Hb on admission are associated with higher rates of in-hospital mortality, heart failure and major bleeding after p-PCI.

Keywords

Hemoglobin Myocardial infarction Percutaneous coronary intervention Prognosis