Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry.
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Daoulah Amin, Jameel Naser Maryam, Hersi Ahmad, Yousif Nooraldaem, Alasmari Abdulaziz, Almahmeed Wael, AlZahrani Hazza A, Aljohar Alwaleed, Alshehri Mohammed, Alzahrani Badr, Basudan Duna, Alosaimi Hind, Abuelatta Reda, Al Garni Turki, Ghani Mohamed Ajaz, Amin Haitham, Noor Husam A, Hashmani Shahrukh, Al Nasser Faisal Omar M, Kazim Hameedullah M, Wael Refaat Wael Refaat, Selim Ehab, Jamjoom Ahmed, El-Sayed Osama, Hassan Taher, Dahdouh Ziad, Aithal Jairam, Diab Ahmed, Ibrahim Ahmed M, Elganady Abdelmaksoud, Qutub Mohammed A, Alama Mohamed N, Abohasan Abdulwali, Tawfik Wael, Balghith Mohammed, Abualnaja Seraj, Fathey Hussien Adnan, Abdulhabeeb Ibrahim A M, Ahmad Osama, Ramadan Mohamed, Alqahtani Abdulrahman H, Al Samadi Faisal, Qenawi Wael, Shawky Ahmed, Ghonim Ahmed A, Arafat Amr A, Elmahrouk Ahmed, Elmahrouk Youssef, Hiremath Niranjan, Shawky Abeer M, Asrar Farhan M, Farghali Tarek, Altnji Issam, Aljohani Khalid, Alotaiby Mohammed, Alqahtani Abdulrahman M, Lotfi Amir
Аннотация
METHODS: This was a retrospective, multicenter, observational study conducted between January 2015 and December 2019. The data on patients with ULMCA who underwent revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) were stratified by the hemoglobin level at baseline into anemic and non-anemic groups to compare in-hospital events. The pre-discharge hemoglobin following revascularization was categorized into very low (<80 g/L for men and women), low (≥80 and ≤119 g/L for women and ≤129 g/L for men), and normal (≥130 g/L for men and ≥120 g/L for women) to assess impact on follow-up outcomes.
RESULTS: A total of 2,138 patients were included, 796 (37.2%) of whom had anemia at baseline. A total of 319 developed anemia after revascularization and moved from being non-anemic at baseline to anemic at discharge. There was no difference in hospital major adverse cardiac and cerebrovascular event (MACCE) and mortality between CABG and PCI in anemic patients. At a median follow-up time of 20 months (interquartile range [IQR]: 27), patients with pre-discharge anemia who underwent PCI had a higher incidence of congestive heart failure (CHF) (p < 0.0001), and those who underwent CABG had significantly higher follow-up mortality (HR: 9.85 (95% CI: 2.53-38.43), p = 0.001).
CONCLUSION: In this Gulf LM study, baseline anemia had no impact upon in-hospital MACCE and total mortality following revascularization (PCI or CABG). However, pre-discharge anemia is associated with worse outcomes after ULMCA disease revascularization, with significantly higher all-cause mortality in patients who had CABG, and a higher incidence of CHF in PCI patients, at a median follow-up time of 20 months (IQR: 27).