Effect Of Admission Hemoglobin Level On Long-term Prognosis Of Patients After Percutaneous Coronary Intervention

Objective: to investigate the relationship between admission hemoglobin levels and long-term prognosis of coronary artery disease(CHD)patients undergoing percutaneous coronary intervention(PCI).Methods: retrospective cohort study was conducted to collect clinical data of patients with coronary heart disease after PCI admitted to the first affiliated hospital of xinjiang medical university from January 2008 to December 2016,as well as data of hemoglobin level,basic biochemical data and cardiovascular disease-related risk factors.Follow-up endpoints were set: death,bleeding events,major cardio-cerebral vascular adverse events(MACCE).An average follow-up of(35.9 ±22.6)months was performed.The final inclusion of 6 046 patients was divided into 4groups according to the quartile of hemoglobin levels admitted: Q1 group(?129 g/L,n= 1 398),Q2 group(130–140 g/L,n =1 526),Q3 group(141-150 g/L,n =1 533)and Q4group(>150 g/L,n=1 589).Results:Males' proportion,age,smoking,alcohol consumption,diabetes,hypertension,body mass index,heart rate,diastolic blood pressure,serum creatinine,blood uric acid,urea nitrogen,blood glucose group werestatistically significant(P<0.05).During the follow-up period,there were 309 all-cause deaths(ACM),including 96(6.9%)in Q1 group,84(5.5%)in Q2 group,68(4.4%)in Q3 group,and 61(3.8%)in Q4 group.A total of 251 cases of cardiogenic death(CM)occurred,including 78 cases(5.6%)in Q1 group,65 cases(4.3%)in Q2 group,55 cases(3.6%)in Q3 group,and 53 cases(3.3%)in Q4 group;There were 862 major cardiac and cerebrovascular adverse events(MACCE),including 219(15.7%)in Q1,243(15.9%)in Q2,197(12.9%)in Q3,and 203(12.8%)in Q4.With the decrease of hemoglobin level,all-cause death,cardiogenic death,MACCE incidence increased,the incidence of bleeding events were not statistically different between the four groups.Multivariate COX regression analysis showed that the mortality increased by 2 054 times compared with hemoglobin >150 g/L and hemoglobin ?120 g/L(HR=2.054 [1.063-3.967],P=0.032);When hemoglobin(130 g/L-140 g/L),the mortality increased by 2 092 times(HR=2.092 [1.139-3.842],P=0.017);When hemoglobin(141 g/L-150 g/L),the mortality increased by 1.876 times(HR=1.876 [1.009-3.491],P=0.047),Hemoglobin level can be an independent risk factor for long-term mortality after PCI.Conclusion: Low hemoglobin levels are associated with poor prognosis after PCI and are independent predictors of all-cause mortality.