Association of Hemoglobin Level with In-Hospital Outcomes in Patients with STEMI Treated with Primary Percutaneous Coronary Intervention

Abstract

Objectives: This study aimed to investigate the relationship between post-percutaneous coronary intervention (PCI) hemoglobin levels and in-hospital outcomes in patients with ST-elevation myocardial infarction (STEMI). Methodology: A retrospective cohort study was conducted on 120 STEMI patients undergoing primary PCI at Hayatabad Medical Complex, Peshawar, from January to December 2023. Patients were stratified into three groups based on post-PCI hemoglobin levels: normal, mildly anemic, and severely anemic. Inclusion criteria included STEMI patients aged ≥18 years with complete medical records, while those with active post-procedural bleeding were excluded. Data collected encompassed pre- and post-PCI hemoglobin levels, comorbidities (chronic kidney disease, diabetes, hypertension), anemia treatment details, and in-hospital outcomes. Multivariate regression analysis was performed to identify independent predictors of outcomes. Results: Lower post-PCI hemoglobin levels were significantly associated with increased in-hospital mortality and major adverse cardiac events (MACE). Mortality rates were 4.0%, 10.0%, and 20.0% in the normal, mildly anemic, and severely anemic groups, respectively (p=0.02). MACE occurred in 6.0%, 17.5%, and 30.0% of these groups (p=0.01). Severe anemia was an independent predictor of mortality (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.1–5.7, p=0.03) and MACE (OR 3.2, 95% CI 1.4–7.2, p=0.01). Comorbid conditions, including chronic kidney disease, diabetes, and hypertension, further amplified these risks. Conclusion: Post-PCI hemoglobin levels play a pivotal role in determining in-hospital outcomes in STEMI patients. Addressing anemia and associated comorbidities is crucial for improving prognosis. Implementation of comprehensive anemia management strategies is essential to optimize patient care and enhance survival rates.