Impact of admission anemia on coronary microcirculation and clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Yasuhiro Uchida, Satoshi Ichimiya, Hideki Ishii, Masaaki Kanashiro, Junji Watanabe, Shinji Hayano, Susumu Suzuki, Kyosuke Takeshita, Shinichi Sakai, Tetsuya Amano, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Microvascular dysfunction after primary percutaneous coronary intervention (PCI) augments myocardial damage and prognosis in acute myocardial infarction. However, the relationship between baseline anemia and coronary microcirculation in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. We performed primary PCI in 337 consecutive patients with STEMI. Anemia was defined as a hemoglobin level < 13 g/dL in men and < 12 g/ dL in women. Admission anemia was present in 17.5% of the patients enrolled. Data on epicardial coronary flow, STsegment resolution (STR) on electrocardiography, myocardial injury, and the incidence of adverse cardiac events defined as cardiac death or hospitalization for congestive heart failure were analyzed. The median follow-up period was 54.8 months. Despite comparable epicardial coronary flow, the rate of STR ≥ 50% was lower in anemic patients compared with non-anemic patients (55.9% versus 71.2%, P = 0.02). On multivariate logistic regression analysis, baseline anemia was an independent negative predictor of STR ≥ 50% (odds ratio, 0.53; 95% confidence interval: 0.31-0.92, P = 0.03). Moreover, anemic patients had higher maximum creatine kinase levels normalized for body surface area (2,215 ± 1,318 IU/L/m2 versus 1,797 ± 1,199 IU/L/m2, P = 0.047). Anemia remained an independent significant predictor of adverse events on multivariate Cox proportional hazard analysis (hazard ratio, 2.34; 95% confidence interval: 1.01-5.64, P = 0.048). In conclusion, admission anemia was related to microcirculatory dysfunction and poor prognosis in patients with STEMI. The decreased oxygen delivery might exacerbate microvascular function.

Original languageEnglish
Pages (from-to)381-388
Number of pages8
JournalInternational heart journal
Volume56
Issue number4
DOIs
Publication statusPublished - 13-07-2015

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Impact of admission anemia on coronary microcirculation and clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention'. Together they form a unique fingerprint.

Cite this