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Volume : 25 Issue : 9 Year : 2021
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Post percutaneous coronary intervention hemoglobin levels predict in-hospital mortality in patients with STEMI treated with primary percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(9): 623-629 | DOI: 10.5152/AnatolJCardiol.2021.07282

Post percutaneous coronary intervention hemoglobin levels predict in-hospital mortality in patients with STEMI treated with primary percutaneous coronary intervention

Gönül Zeren1, İlhan İlker Avcı1, Barış Şimşek1, Azmi Sungur1, Tufan Çınar2, Veysel Ozan Tanık3, Duygu Genç1, Göksel Çinier1, Can Yücel Karabay1
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
2Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital; İstanbul-Turkey
3Department of Cardiology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital; İstanbul-Turkey

Objective: In this study, we aimed to determine whether admission hemoglobin versus post-percutaneous coronary intervention (PCI) hemoglobin level at 24 hours is a predictor of in-hospital mortality for patients with ST elevation myocardial infarction (STEMI) without evidence of clinical hemorrhage who underwent primary PCI.
Methods: In this study, we included 1,444 consecutive patients with STEMI who underwent primary PCI at a tertiary heart hospital. The primary outcome of the study was the in-hospital all-cause mortality. We used the penalized maximum likelihood estimation (PMLE) logistic regression method to examine the relationship between primary outcome and candidate predictors.
Results: In total, 172 (11.9%) patients died during the in-hospital course. According to a PMLE logistic regression analysis, age, KILLIP class ≥2, pre-PCI thrombolysis in myocardial infarction (TIMI) flow <3, systolic blood pressure, creatinine, glycoprotein IIb/IIIa inhibitor use, and post-PCI hemoglobin levels at 24 hours were predictors of in-hospital mortality. The relative importance of post-PCI hemoglobin at 24 hours (contributing 6% of the explainable outcome in the model) was significantly higher than admission hemoglobin (contributing only 0.1% of the explainable outcome in the model).
Conclusion: This study demonstrated that post-PCI hemoglobin levels were independently associated with in-hospital survival in patients with STEMI without evidence of bleeding following primary PCI. In addition, post-PCI hemoglobin was a better predictor of in-hospital mortality than admission hemoglobin for patients with STEMI who underwent primary PCI.

Keywords: post-percutaneous coronary intervention hemoglobin, admission hemoglobin, ST-segment elevation myocardial infarction, primary percutaneous coronary intervention, in-hospital mortality

Gönül Zeren, İlhan İlker Avcı, Barış Şimşek, Azmi Sungur, Tufan Çınar, Veysel Ozan Tanık, Duygu Genç, Göksel Çinier, Can Yücel Karabay. Post percutaneous coronary intervention hemoglobin levels predict in-hospital mortality in patients with STEMI treated with primary percutaneous coronary intervention. Anatol J Cardiol. 2021; 25(9): 623-629

Corresponding Author: Gönül Zeren, Türkiye