Impact of anemia on clinical outcomes in patients with multivessel coronary artery disease treated with percutaneous coronary intervention.

Introduction: Coronary artery disease (CAD) remains one of the major problems of contemporary medicine. Hematological disorders seem to play an important role in progression and severity of CAD. The aging of the population results in an increase in the number of patients with both CAD and anemia.

Aim: To assess the impact of anemia on clinical outcomes in patients with multivessel CAD who underwent percutaneous coronary intervention (PCI) in long-term follow-up.

Material and methods: In this retrospective study we examined 6-year outcomes of 679 individuals with multivessel CAD treated with PCI based on the hemoglobin (HGB) value before the interventional procedure. We classified the participants into two groups: anemia and non-anemia. The primary endpoint was overall mortality. Secondary endpoints were major adverse cardiac or cerebrovascular events (MACCE) (i.e. overall mortality, stroke, myocardial infarction (MI), or repeat revascularization (RR)) and separate components of MACCE.

Results: We found that 35.4% (240 out of 679) of the patients were anemic. The occurrence of the primary endpoint significantly differed between anemia and non-anemia-groups (48/240 (20.0%) vs. 51/439 (11.6%), p = 0.003). The co-existence of anemia was associated with increased rates of MACCE, MI and in-hospital mortality (177/240 (73.8%) vs. 211/439 (48.1%); 51/240 (21.3%) vs. 44/439 (10.0%) and 21/240 (8.8%) vs. 4/439 (0.9%) for non-anemia, p < 0.001 for all, respectively).

Conclusions: Our research identified an important risk factor for stratifying PCI patients. Given the high incidence of anemia in CAD patients undergoing PCI, HGB levels should be assessed upon admission and factored into risk stratification.