Implications of anemia in patients undergoing PCI with Impella-support: insights from the PROTECT III study

Authors

Batla Falah
Björn Redfors
Duzhi Zhao
Aditya S. Bharadwaj
Mir B. Basir, Henry Ford HealthFollow
Julia B. Thompson
Rajan A. G. Patel
Michael J. Schonning
Arsalan Abu-Much
Yiran Zhang
Wayne B. Batchelor
Cindy L. Grines
William W. O'Neill, Henry Ford HealthFollow

Recommended Citation

Falah B, Redfors B, Zhao D, Bharadwaj AS, Basir MB, Thompson JB, Patel RAG, Schonning MJ, Abu-Much A, Zhang Y, Batchelor WB, Grines CL, and O'Neill WW. Implications of anemia in patients undergoing PCI with Impella-support: insights from the PROTECT III study. Front Cardiovasc Med 2024; 11:1429900.

Document Type

Article

Publication Date

1-1-2024

Publication Title

Front Cardiovasc Med

Abstract

BACKGROUND: Anemia is prevalent among patients with cardiovascular disease and is associated with adverse outcomes. However, data regarding the impact of anemia in high-risk percutaneous coronary intervention (HRPCI) are limited.

OBJECTIVES: This study aimed to evaluate the impact of anemia in patients undergoing Impella-supported HRPCI in the PROTECT III study.

METHODS: Patients undergoing Impella-supported HRPCI in the multicenter PROTECT III study were assessed for anemia based on baseline hemoglobin levels according to World Health Organization criteria. Patients were stratified into three groups, namely, no anemia, mild anemia, and moderate or severe anemia. Major adverse cardiovascular and cerebrovascular events (MACCE: all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeat revascularization) at 30 and 90 days, and major bleeding events were compared across groups.

RESULTS: Of 1,071 patients with baseline hemoglobin data, 37.9% had no anemia, 43.4% had mild anemia, and 18.7% had moderate or severe anemia. Anemic patients were older and more likely to have comorbidities. Anemia was associated with higher MACCE rates at 30 days (moderate to severe, 12.3%; mild, 9.8%; no anemia, 5.4%; p = 0.02) and at 90 days (moderate to severe, 18.7%; mild, 14.6%; none, 8.3%; p = 0.004). These differences persisted after adjustment for potential confounders at 30 and 90 days, and sensitivity analysis excluding dialysis showed similar results. Major bleeding at 30 days was also higher in anemic patients (5.5% vs. 1.2%, p = 0.002).

CONCLUSION: Baseline anemia in Impella-supported HRPCI is common and independently associated with MACCE and major bleeding, emphasizing its significance as a prognostic factor

PubMed ID

39091353

Volume

11

First Page

1429900

Last Page

1429900