In Hospital Prognosis in Patients Treated with Primary Percutaneous Coronary Intervention, Role of Admission Hemoglobin Level
DOI:
https://doi.org/10.47672/ajhmn.1319Keywords:
Hemoglobin, STEMI, PCIAbstract
Purpose: Hemoglobin level is associated with outcomes and complications in ST segment Myocardial Infarction (STEMI) patients. The aim of the study is was to evaluate the correlation between admission Hemoglobin level and the incidence of in hospital complications in patients with STEMI treated with primary Percutaneous Intervention (pPCI).
Methodology: This was an observational study recruiting STEMI patients at the National Heart Institute. Admission Hemoglobin level withdrawn and the patients receiving pPCI was followed up during their hospital stay for incidence of complications including new significant arrhythmias, no reflow, stroke, contrast induced nephropathy (CIN). Duration of hospital stay was used as an overall indication of incidence of complication. Patients receiving lytic therapy, parenteral antiplatelet, receiving urgent CABG were excluded from the study. Out of 173 patients presented with STEMI to the National Heart Institute in Egypt and recruited for the study, 106 patients only were included in the study.
Findings: Significant correlation between admission Hemoglobin level and incidence of new significant arrhythmias, no reflow and prolonged duration of hospital stay P-value (P <0.009, P <0.000, Prob > chi2 = 0.001) respectively. There was a significant association between hemoglobin level at the time of admission in STEMI patients and incidence of in-hospital complications including different types of arrhythmias, no reflow phenomenon, and prolonged duration of hospital stay.
Recommendation: All the precautions should be taken by health care providers with efficient team work to avoid no reflow in anemic and polycythemic patients presenting with STEMI in primary intervention.
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References
WHO. Cardiovascular diseases (CVDs) key facts. Who [Internet]. 2021;(June):1-5. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds
Ibanez B,"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation," Eur. Heart J., vol. 39, pp. 119-177, 2018,
Rubini M Gimenez, "Sex-Specific Management in Patients with Acute Myocardial Infarction and Cardiogenic Shock: A Substudy of the CULPRIT-SHOCK Trial," Circ. Cardiovasc. Interv., vol25,pp.225-320,2020.
Hosseini S, Ansari, M, J Tokaldany,M,L et al.,"Association between preprocedural hemoglobin level and 1-year outcome of elective percutaneous coronary intervention," J. Cardiovasc. Med., vol.3,pp.16,2014.
Kim, B, G et al., "Relation of Preprocedural Hemoglobin Level to Outcomes After Percutaneous Coronary Intervention," Am. J. Cardiol., vol. 124, pp. 1319-1326, 2019
Tang, C et al., "Usefulness of Haemoglobin Level Combined with CAMI-STEMI Score for Predicting MACCE in Patients with Acute ST-Elevation Myocardial Infarction after PCI," Biomed Res. Int.,vol.3,pp.24-25,2019.
Uchida Y et al., "Impact of admission anemia on coronary microcirculation and clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention," Int. Heart J.,vol.13,pp.125-130,2015.
Sertcakacilar, G "Association between Anemia and New-Onset Atrial Fibrillation in Critically Ill Patients in the Intensive Care Unit : A Retrospective Cohort Analysis," pp. 533-544, 2022.
Xu,D Murakoshi, N and Sairenchi,T "Anemia and Reduced Kidney Function as Risk Factors for New Onset of Atrial Fibrillation ( from the Ibaraki Prefectural Health Study )," Am. J. Cardiol., vol. 115, no. 3, pp. 328-333, 2015.
Lim,W Choi,E Han,K Lee,S, and Cha, M,"Impact of Hemoglobin Levels and Their Dynamic Changes on the Risk of Atrial Fibrillation : A Nationwide Population-Based Study," Sci. Rep., pp. 1-8, 2020.
Heart I,J,C et al., "Clinical relationship between anemia and atrial fibrillation recurrence after catheter ablation without genetic background," IJC Hear. Vasc., vol. 27, pp. 100507, 2020.
Rezkalla S.H, Kloner R.A, "No-Reflow Phenomenon," American Heart Association Journal vol.30,pp. 656-662, 2002.
Jaffe, R Charron. T, Puley.G, Dick.A, and Strauss.B.H, "Microvascular obstruction and the no-reflow phenomenon after percutaneous coronary intervention," Circulation, vol. 117, pp. 3152-3156, 2008.
Isik.T, Kurt.M , Ayhan.E , TanbogaI , Ergelen.M, and Uyarel.H , "The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention," Atherosclerosis, vol. 224, pp. 143-149, 2012.
Yaylak.B ,"Relation of hemoglobin level to no-reflow in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention," Postep. w Kardiol. Interwencyjnej,vol.13,pp.65-70,2018.
Lun.Z ,"The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1.2 million patients," J. Nephrol., vol. 34, pp. 1479-1489, 2021.
Li.W.H,. Li.D,Y, Han.F, Xu.T.D,. Zhang.Y.B, and Zhu.H, "Impact of anemia on contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary interventions," Int. Urol. Nephrol., vol. 45, pp. 1065-1070, 2013.
Wester.W ,"Impact of Baseline Anemia in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: A Prespecified Analysis From the VALIDATE-SWEDEHEART Trial," J. Am. Heart Assoc., vol. 8, pp. 16, 2019.
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Copyright (c) 2023 Amro Elnagar, Neama Elmelegy, Ahmed Abdelmonaem, Ahmed Magdy
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