Key result
Combined low baseline hemoglobin and creatinine clearance in STEMI patients undergoing primary PCI was associated with higher 30-day adverse events compared to normal levels (19.2% vs 2.0%, P=0.01).
Why the study?
The study sought to evaluate the impact of baseline hemoglobin and creatinine clearance levels in acute STEMI patients undergoing primary PCI.
Do low baseline hemoglobin and creatinine clearance levels predict adverse events in STEMI patients undergoing primary PCI?
Observational (n=337)
No
Do low baseline hemoglobin and creatinine clearance levels predict adverse events in STEMI patients undergoing primary PCI?
Absolute Event Rate: 19.2% vs 2%
p-value: p=0.01
Concomitant low hemoglobin and low creatinine clearance at baseline are associated with significantly higher 30-day adverse events and mortality in STEMI patients undergoing primary PCI.
Baseline Hb and CrCl may refine in-hospital risk stratification in STEMI primary PCI; leaves open prospective validation before guiding care.
Objective: The objective is to evaluate the impact of baseline hemoglobin (Hb) levels and creatinine clearance (CrCl) levels in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Methods: This was a single-center, prospective observational study conducted at a tertiary-care center in India. We enrolled 337 STEMI patients between November 2015 and December 2016. Patients were divided into four groups on the basis of baseline Hb and CrCl levels: Group-1: patients with normal Hb and normal CrCl (102 [30.2%]); Group-2: patients with low Hb and normal CrCl (78 [23.2%]); Group-3: patients with normal Hb and low CrCl (79 [23.4%]); and Group-4: patients with low Hb and low CrCl (78 [23.2%]). Results: The mean age group at presentation was 40–70 years. In-hospital complications were observed in 11 (10.8%) patients of Group-1, 11 (14.1%) patients of Group-2, 37 (46.8%) patients of Group-3, and 52 (66.7%) patients of Group-4, respectively ( P = 0.03). Adverse events at 30-day follow-up were found to be higher in Group-4 (15 [19.2%] patients) followed by Group-3 (8 [10.1%] patients), Group-2 (4 [5.1%] patients), and Group-1 (2 [2%] patients), respectively ( P = 0.01). Death was observed in one (1%) patient of Group-1, three (3.8%) patients of Group-2, five (6.3%) patients in Group-3, and eight (10.3%) patients of Group-4 ( P = 0.03). Conclusion: Low Hb levels and CrCl levels in acute STEMI patients undergoing primary PCI were associated with increased risk of 30-day event rates.
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Chandra et al. (2020) conducted an observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=337). Low baseline hemoglobin and low creatinine clearance vs. Normal baseline hemoglobin and normal creatinine clearance was evaluated on Adverse events at 30-day follow-up (p=0.01). Combined low baseline hemoglobin and creatinine clearance in STEMI patients undergoing primary PCI was associated with higher 30-day adverse events compared to normal levels (19.2% vs 2.0%, P=0.01).
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