FREQUENCY OF POST-PROCEDURE ANEMIA IN PATIENTS AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION
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Keywords
Anemia, ST-Elevation Myocardial Infarction (STEMI), Percutaneous Coronary Intervention (PCI), Post-Procedure Complications, Hemoglobin Monitoring, Clinical Outcomes
Abstract
Background: Anemia is common among acute coronary syndrome (ACS) patients and is linked to higher morbidity and mortality rates. Primary percutaneous coronary intervention (PCI) is the preferred treatment for ST-Elevation Myocardial Infarction (STEMI), yet anemia following the procedure remains a significant issue affecting patient recovery and long-term outcomes.
Objectives: This research aims to assess the prevalence and severity of post-PCI anemia in STEMI patients and to identify associated demographic and clinical factors.
Methods: Conducted over six months at the National Institute of Cardiovascular Disease (NICVD) in Karachi, this cross-sectional study included 196 patients aged 18 to 70 with normal pre-procedure hemoglobin levels, diagnosed with STEMI, and who underwent primary PCI. Demographic and clinical data, along with post-procedure hemoglobin levels, were collected and analyzed using SPSS version 21.
Results: The participants had an average age of 56.3 years, with males representing 58.2% of the sample. The average body mass index (BMI) was 26.5 kg/m². Post-procedure anemia was observed in 46.9% of patients, classified into mild (23.9%), moderate (48.9%), and severe (27.2%). Anemia prevalence did not significantly differ across various demographic and clinical factors like age, gender, obesity, smoking status, diabetes, hypertension, and family history of coronary artery disease (CAD).
Conclusion: The notable prevalence of anemia post-PCI emphasizes the importance of routine hemoglobin monitoring and individualized management strategies for STEMI patients undergoing PCI. Early detection and treatment of anemia could enhance clinical outcomes and reduce hospital readmissions. Future research should focus on establishing evidence-based guidelines for anemia management in this patient group.
References
2. Mamas MA, Kwok CS, Kontopantelis E, Fryer AA, Buchan I, Bachmann MO, et al. Relationship between anemia and mortality outcomes in a national acute coronary syndrome cohort: insights from the UK myocardial ischemia national audit project registry. J Am Heart Assoc. 2016;5.
3. Tsujita K, Nikolsky E, Lansky AJ, Dangas G, Fahy M, Brodie BR, et al. Impact of anemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy (from the HORIZONS-AMI trial). Am J Cardiol. 2010;105:1385–94.
4. Nikolsky E, Aymong ED, Halkin A, Grines CL, Cox DA, Garcia E, et al. Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: analysis from the controlled abciximab and device investigation to lower late angioplasty complications (CADILLAC) trial. J Am Coll Cardiol. 2004;44:547–54.
5. Valente S, Lazzeri C, Chiostri M, Sori A, Giglioli C, Gensini GF. Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role? Intern Emerg Med. 2011;6:329–36.
6. Carson JL, Brooks MM, Abbott JD, Chaitman B, Kelsey SF, Triulzi DJ, et al. Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J. 2013;165:964.e1–971.e1.
7. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation. 2016;133:1135–47.
8. Muhammad Dilawaer Khan, Jahan Tab Qazi, Hamza Maqsood, Shaheryar Qazi, Khurram Irshad, Hassan Abdullah Shakeel. Anaemia in acute coronary syndrome: a cross-sectional study. Int J Res Med Sci. 2019;7(8):3030-3035.
9. McKechnie RS, Smith D, Montoye C, Kline-Rogers E, O’Donnell MJ, DeFranco AC, et al. Prognostic implication of anemia on in-hospital outcomes after percutaneous coronary intervention. Circulation. 2004;110:271–7.
10. Shacham Y, Leshem-Rubinow E, Ben-Assa E, Roth A, Steinvil A. Lower admission hemoglobin levels are associated with longer symptom duration in acute ST-elevation myocardial infarction. Clin Cardiol. 2014;37:73–7.
11. Riley RF, Newby LK, Don CW, Alexander KP, Peterson ED, Peng SA, et al. Guidelines-based treatment of anaemic STEMI patients: practice patterns and effects on in-hospital mortality: a retrospective analysis from the NCDR. Eur Heart J Acute Cardiovasc Care. 2013;2:35–43.
12. Salisbury AC, Alexander KP, Reid KJ, Masoudi FA, Rathore SS, Wang TY, et al. Incidence, correlates, and outcomes of acute, hospital-acquired anemia in patients with acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2010;3(4):337–46.
13. Lee WC, Fang HY, Chen HC, Chen CJ, Yang CH, Hang CL, et al. Anemia: a significant cardiovascular mortality risk after ST-segment elevation myocardial infarction complicated by the comorbidities of hypertension and kidney disease. PLoS One. 2017;12.
14. Wu WC, Rathore SS, Wang Y, Radford MJ, Krumholz HM. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med. 2001;345(17):1230–6.
15. Manoukian SV. Predictors and impact of bleeding complications in percutaneous coronary intervention, acute coronary syndromes, and ST-segment elevation myocardial infarction. Am J Cardiol. 2009;104(suppl):9C–15.
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Aneel Ahmed
Post Fellow in Cardiac Imaging, National Institute of Cardiovascular Diseases, Karachi Pakistan.
Zafar Iqbal
Post Fellow Cardiac Imaging, National Institute Of Cardiovascular Diseases Karachi Pakistan.
Asim Ali
Post Fellow Interventional Cardiology, National Institute of Cardiovascular Diseases Karachi, Pakistan
Abdul Rahman
FCPS Cardiology, Post Fellow Critical Care Medicine, National Institute of Cardiovascular Disease, Karachi Pakistan
Deepak Lal
FCPS Cardiology, National Insititute of Cardiovascular Disease and Cardiologist at Zayed Military Hospital Abu Dhabi, United Arab Emirates.
Rabel Hassan
Diagnostic Radiology Resident, Dr.Ruth K.M.Pfau/ Civil Hospital Karachi, Pakistan.