Key result
Hemoglobin decline ≥3 g/dL after STEMI PCI is linked to ~63% higher long-term mortality.
Why the study?
To explore the association between in-hospital haemoglobin decline and long-term mortality and MACCE among STEMI patients treated with primary PCI.
Does high in-hospital haemoglobin decline increase long-term mortality and MACCE in adult STEMI patients undergoing primary PCI?
Cohort (n=766)
Does high in-hospital haemoglobin decline increase long-term mortality and MACCE in adult STEMI patients undergoing primary PCI?
Absolute Event Rate: 52% vs 32%
An in-hospital haemoglobin decline of ≥3 g/dl after primary PCI for STEMI is strongly associated with increased long-term mortality and MACCE, even in the absence of visible bleeding.
May warrant heightened post-PCI haemoglobin vigilance in STEMI; leaves open whether mitigating decline improves survival.
OBJECTIVE: To explore the association between in-hospital haemoglobin decline and long-term mortality and major adverse cardiovascular and cerebrovascular events (MACCE) among ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). METHODS: This retrospective analysis included adult patients who underwent primary PCI for STEMI. Haemoglobin levels were recorded at admission and 48-72 h later. Patients were divided into two groups based on the extent of haemoglobin decline: low (<3 g/dl or no decline) and high (≥3 g/dl). The primary endpoint was all-cause mortality at long-term follow-up. The secondary endpoint was MACCE. RESULTS: = 111). The mortality rate was significantly higher in the high group (72 of 111 patients; 65%) than in the low group (185 of 655 patients; 28%). Propensity score matching confirmed this association, with higher mortality (41 of 79 patients [52%] versus 25 of 79 patients [32%]) and MACCE rates (56 of 79 patients [71%] versus 41 of 79 patients [52%]) in the high group compared with the low group, respectively. CONCLUSION: There was a significant association between in-hospital haemoglobin decline, even without visible bleeding, and increased long-term mortality and MACCE in STEMI patients undergoing primary PCI.
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Esin et al. (2024) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=766). High haemoglobin decline (≥3 g/dl) vs. Low haemoglobin decline (<3 g/dl or no decline) was evaluated on all-cause mortality at long-term follow-up. In-hospital haemoglobin decline ≥3 g/dl in STEMI patients undergoing primary PCI was associated with significantly higher long-term mortality compared to a decline <3 g/dl (52% vs 32% after matching).
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