Impact Of Admission Hemoglobin Level On One Year Prognosis Of Patients With Acute ST-segment Elevation Myocardial Infarction

ObjectiveTo investigate the relationship between admission hemoglobin level and the prognosis of patients with STEMI after percutaneous corornary invervention(including emergency and selective strategy), and provide effective reference index for the prognosis of STEMI.MethodThis study including 815 cases of hospitalized patients with initial STEMI(female 213 cases, male 602 cases, age 30-95 years old), infarction related artery(IRA) which was total occlusion lesion or subtotal occlusion lesion with TIMI 0-1 level revealed by CAG, all underwent percutaneous corornary invervention(including emergency and selective PCI). After PCI, all patients were followed up for 3 months, 6 months, 9 months and 12 months by phone call and we adopted the Major Adverse Cardiac Events( the first rehospitalization incident and all-cause death incident all induced by cardiac diseases) occurrence time, and did statistical analysis. By analyzing the basic clinical data of STEMI patients, ascertaining the effective reference indexes impacting on prognosis;We grouped the patients by survival group and death group, analyzed the relationship between admission hemoglobin level and the mortality of patients with STEMI after PCI;We regrouped the survival group by the first rehosipitalized group and normal group, analyzed the relationship between admission hemoglobin level and the rehosipitalization rate of patients with STEMI after PCI.Result1、According to analyzing the basic clinical data of STEMI patients, the mortality of patients with STEMI after PCI had correlation with age, admission Hb level and Killip gradation and they all showed statistical significance between the survival and death group(P<0.05). After adjusted for factors including age, dyslipidemia, diabetes, the level of hemoglobin was still correlated with the mortality of patients with STEMI after PCI(P<0.05). However, factors including gender, drinking, smoking, diabetes, dyslipidemia, hypertension, cerebrovascular events, ALT, AST, WBC, PLT, TC, TG, HDL-C, LDL-C, Na+, K+, vascular lesion counts and medication had no significant impact on the mortality of patients with STEMI after PCI( P>0.05).2、According to follow-up results, we grouped the patients by anemia group and non-anemia group, all-cause death events as outcome events, and did survival analysis via Kaplan-Meier statistical method. Combined with survival analysis results, the mortality rate of anemia group was significantly higher than that of the other group(P<0.05).3、According to analyzing the basic clinical data of survival group, admission Hb level had no value of predict the first rehospitalization rate induced by cardiogenic diseases(P>0.05).4、According to follow-up results, we regrouped the survival group by anemia group and non-anemia group, the first rehospitalization events induced by cardiogenic diseases as outcome events, and did survival analysis via Kaplan-Meier statistical method. Combined with survival analysis results, the two group had no significant diffrence(P<0.05).Conclusion1、The STEMI patients of lower Hb level, older age and higher Killip gradation will be at higher risk for adverse event occurrence than higher Hb level, younger age and lower Killip gradation.2、Low admission Hb level has a predicted value of the mortality of initial STEMI patients who undergo PCI and can be used as independent risk factor, but admission Hb level has no value of predict the first rehospitalization rate induced by cardiogenic diseases.