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. 2024 Oct;52(10):3000605241285241.
doi: 10.1177/03000605241285241.

Association between haemoglobin decline and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention

Fatma Esin  1 , Hüseyin Sefa Ince  1 , Gökhun Akkan  2 , Ugur Kocabas, Tuncay Kiris  1 , Aykan Celik  1 , Mustafa Karaca  1
Affiliations

Association between haemoglobin decline and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention

Fatma Esin et al. J Int Med Res. 2024 Oct.

Abstract

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: Patients were divided into two groups: low group (n = 665) and high group (n = 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.

Keywords: Haemoglobin decline; ST-segment elevation myocardial infarction; STEMI; long-term mortality; primary percutaneous coronary intervention.

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Conflict of interest statement

Declaration of conflicting interestThe authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Mortality before propensity score matching in the entire cohort of patients (n = 766) who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 2.
Figure 2.
Major cardiovascular and cerebrovascular events (MACCE) before propensity score matching in the entire cohort of patients (n = 766) who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 3.
Figure 3.
Mortality before propensity score matching in patients (n = 94) with overt bleeding who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 4.
Figure 4.
Major cardiovascular and cerebrovascular events (MACCE) before propensity score matching in patients (n = 94) with overt bleeding who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 5.
Figure 5.
Mortality after propensity score matching in patients (n = 158) who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 6.
Figure 6.
Major cardiovascular and cerebrovascular events (MACCE) after propensity score matching in patients (n = 158) who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 7.
Figure 7.
Mortality after propensity score matching in patients (n = 37) with overt bleeding who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
Figure 8.
Figure 8.
Major cardiovascular and cerebrovascular events (MACCE) after propensity score matching in patients (n = 37) with overt bleeding who experienced ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention who were enrolled in a study investigating the association between in-hospital haemoglobin decline and long-term mortality. Patients were stratified according to the extent of haemoglobin decline into low and high groups. The colour version of this figure is available at: http://imr.sagepub.com.
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