ABSTRACT Background It is unclear whether preprocedural anemia independently affects outcomes after elective PCI in men with stable CAD. Methods Using the TriNetX US Collaborative Network, we identified adult men undergoing first‐time elective PCI (2016–2024) and compared those with hemoglobin < 13 g/dL (1–7 days pre‐PCI) to non‐anemic controls. Propensity‐score matching produced two balanced cohorts ( n = 1424). Outcomes at 7 days, 30 days, 6 months, and 12 months were analyzed with univariate and multivariable Cox models. Residual confounding was assessed with falsification endpoints and E‐values, and multiplicity with Bonferroni and Benjamini–Hochberg adjustments. Results After propensity‐score matching, 7‐day outcomes were similar between groups. At 30 days, anemia was associated with higher risks of AKI (HR 1.92; 95% CI 1.35–2.72) and major bleeding (HR 2.49; 95% CI 1.48–4.19); however, the 30‐day association with all‐cause hospitalization (HR 1.32; 95% CI 1.05–1.66) did not remain statistically significant after multiplicity adjustment. At 6 months, anemia was linked to higher risks of AKI (HR 2.34; 95% CI 1.84–2.97), mortality (HR 2.63; 95% CI 1.63–4.26), hospitalization (HR 1.56; 95% CI 1.34–1.80), major bleeding (HR 3.28; 95% CI 2.34–4.61), and transfusion (HR 5.47; 95% CI 3.31–9.06); the association with MACE (HR 1.37; 95% CI 1.10–1.70) was sensitive to multiplicity adjustment (significant under false‐discovery‐rate control but not Bonferroni). At 12 months, anemia remained associated with higher risks of AKI (HR 1.96; 95% CI 1.60–2.41), mortality (HR 1.88; 95% CI 1.31–2.70), hospitalization (HR 1.41; 95% CI 1.23–1.62), major bleeding (HR 2.16; 95% CI 1.66–2.81), and transfusion (HR 3.35; 95% CI 2.31–4.85); the association with MACE (HR 1.26; 95% CI 1.03–1.53) did not persist after multiplicity adjustment. Each 1 g/dL increase in hemoglobin was associated with lower risks of AKI and transfusion in univariate Cox models, with similar directionality after adjustment. Conclusions In men undergoing first‐time elective PCI for stable CAD, baseline anemia was associated with higher 12‐month risks of AKI, major bleeding, transfusion, hospitalization, and death—especially with recent (≤ 1 year) bleeding or transfusion.
Shubietah et al. (Thu,) studied this question.