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Effect of Hemoglobin Level on Long-Term All-Cause Mortality After Percutaneous Coronary Intervention in African-Americans
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| 03.05.2009, 14:57 |
Anemia has been shown to be an independent predictor of long-term mortality after
percutaneous coronary intervention (PCI). African-Americans are known to have lower
hemoglobin (Hgb) levels compared with Caucasians. The impact of anemia on long-term
mortality in African-Americans undergoing PCI is unknown. We evaluated a total of 715
African-American patients (313 patients with anemia and 402 patients without anemia as
defined by the World Health Organization [Hgb <13 g/dl for men and <12 g/dl for
women]) using data from our bolus-only glycoprotein IIb/IIIa database. After a median
follow-up of 3.2 years (interquartile range 2.4 to 3.8), there were a total of 72 (10%) deaths.
Survival rate was 84% in the anemic group compared with 94% in the control group
(hazard ratio [HR] 2.8, unadjusted p <0.001 by log-rank test). After adjustment for
baseline clinical and procedural characteristics using a Cox proportional hazards model,
Hgb as a dichotomous variable was a strong and independent predictor of all-cause
mortality during the follow-up period (HR for death 2.0, 95% confidence interval 1.2 to 3.4,
adjusted p 0.012). Also, when Hgb was analyzed as a categorical variable having 3 groups
with empirically determined cutoffs at <11.1, >11.1 to <12.7, and >12.7 g/dl, the effect
remained significant (adjusted p 0.008), with a HR of 2.3 for the group with lowest Hgb
compared with the group with highest value (HR 2.6 for group with Hgb >11.1 to <12.7
compared with the group with the highest Hgb value). In conclusion, baseline Hgb is a
strong and independent predictor of all-cause long-term mortality in African-Americans
undergoing PCI. © 2009 Elsevier Inc. (Am J Cardiol 2009;103:1078 –1082)
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| Категория: Статьи | Добавил: nbylova
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