Hemoglobin Decrease Following Primary Percutaneous Coronary Intervention Can Predict the Incidence of Major Adverse Cardiac Events in Patients with ST-Elevation Myocardial Infarction

Background: Anemia is known predictor for major adverse cardiac events (MACE0 following percutaneous coronary intervention (PCI). We aimed to identify if the changes of hemoglobin following primary PCI is a predictor for 12-month MACE in patients with ST elevation myocardial infarction (STEMI). Methods: We reviewed the data of 452 patients who presented with STEMI to our center underwent successful primary PCI and were followed-up for 12 months at least. Based on 1 gr/dl decline in hemoglobin level following PCI, patients were dichotomized into two groups and were compared for baseline variables as well as the MACE. We also compared the mean of the hemoglobin difference following the procedures to find out its predictive value. Results: During 12-month follow-up, we registered 79 cases of MACE in total. Higher frequencies of total MACE as well as CABG were observed in patients with hemoglobin decrease. The mean level of hemoglobin decrease was significantly higher in patients with MACE as compared with MACE-free patients (-1.5±2.5 vs. -0.8±1.5; HR=1.21, 95% CI: 1.07-1.37; P=0.002). After adjustment for confounders, this difference remained significant (HR=1.18, 95% CI: 1.04-1.34; P=0.10). Conclusion: We observed that changes of hemoglobin before and after the procedure is a predictor for mortality and total MACE.