Relation of Baseline Hemoglobin Level to In-Hospital Outcomes in Patients Who Undergo Percutaneous Coronary Intervention (from a Japanese Multicenter Registry)

Yohei Numasawa, Ikuko Ueda, Mitsuaki Sawano, Toshiki Kuno, Masaki Kodaira, Shigetaka Noma, Masahiro Suzuki, Hiroaki Miyata, Keiichi Fukuda, Shun Kosaka

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Scarce data exist regarding the relation between baseline hemoglobin and in-hospital outcomes after percutaneous coronary intervention (PCI). We studied 13,010 cases of PCI in a Japanese multicenter registry from 2008 to 2016. Patients were divided into 5 groups according to 2-g/dl increments in their preprocedural hemoglobin (from <10 to >16 g/dl). Patients with lower hemoglobin levels were older and had higher proportions of females and co-morbidities, including diabetes mellitus and renal failure, than those with higher hemoglobin levels. In-hospital complications were observed more frequently in patients with lower than higher levels. After adjustment, baseline hemoglobin was inversely associated with total procedural complications (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.84 to 0.90, p <0.001), in-hospital mortality (OR 0.82, 95% CI 0.77 to 0.87, p <0.001), and bleeding complications (OR 0.93, 95% CI 0.88 to 0.98, p = 0.007). Categorically, reverse J-shaped curvilinear correlations were present between baseline hemoglobin and in-hospital adverse outcomes. When the reference group comprised patients with a baseline hemoglobin of 12 to 14 g/dl, patients within the lowest hemoglobin levels (<10 g/dl) were at the highest risk of total procedural complications (OR 2.57, 95% CI 2.07 to 3.17, p <0.001), in-hospital mortality (OR 3.46, 95% CI 2.34 to 5.11, p <0.001), and bleeding complications (OR 2.36, 95% CI 1.70 to 3.25, p <0.001). In subgroup analyses, similar trends were observed in both men and women, and in both patients with acute coronary syndrome and stable coronary artery disease. In conclusion, a low baseline hemoglobin is a simple and powerful predictor of poor outcomes in patients who undergo PCI.

Original languageEnglish
Pages (from-to)695-702
Number of pages8
JournalAmerican Journal of Cardiology
Volume121
Issue number6
DOIs
Publication statusPublished - 2018 Mar 15

Fingerprint

Percutaneous Coronary Intervention
Registries
Hemoglobins
Odds Ratio
Confidence Intervals
Hospital Mortality
Hemorrhage
Acute Coronary Syndrome
Renal Insufficiency
Coronary Artery Disease
Diabetes Mellitus
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation of Baseline Hemoglobin Level to In-Hospital Outcomes in Patients Who Undergo Percutaneous Coronary Intervention (from a Japanese Multicenter Registry). / Numasawa, Yohei; Ueda, Ikuko; Sawano, Mitsuaki; Kuno, Toshiki; Kodaira, Masaki; Noma, Shigetaka; Suzuki, Masahiro; Miyata, Hiroaki; Fukuda, Keiichi; Kosaka, Shun.

In: American Journal of Cardiology, Vol. 121, No. 6, 15.03.2018, p. 695-702.

Research output: Contribution to journalArticle

@article{5353764d120f4b719ac1dfec8abb0336,
title = "Relation of Baseline Hemoglobin Level to In-Hospital Outcomes in Patients Who Undergo Percutaneous Coronary Intervention (from a Japanese Multicenter Registry)",
abstract = "Scarce data exist regarding the relation between baseline hemoglobin and in-hospital outcomes after percutaneous coronary intervention (PCI). We studied 13,010 cases of PCI in a Japanese multicenter registry from 2008 to 2016. Patients were divided into 5 groups according to 2-g/dl increments in their preprocedural hemoglobin (from <10 to >16 g/dl). Patients with lower hemoglobin levels were older and had higher proportions of females and co-morbidities, including diabetes mellitus and renal failure, than those with higher hemoglobin levels. In-hospital complications were observed more frequently in patients with lower than higher levels. After adjustment, baseline hemoglobin was inversely associated with total procedural complications (odds ratio [OR] 0.87, 95{\%} confidence interval [CI] 0.84 to 0.90, p <0.001), in-hospital mortality (OR 0.82, 95{\%} CI 0.77 to 0.87, p <0.001), and bleeding complications (OR 0.93, 95{\%} CI 0.88 to 0.98, p = 0.007). Categorically, reverse J-shaped curvilinear correlations were present between baseline hemoglobin and in-hospital adverse outcomes. When the reference group comprised patients with a baseline hemoglobin of 12 to 14 g/dl, patients within the lowest hemoglobin levels (<10 g/dl) were at the highest risk of total procedural complications (OR 2.57, 95{\%} CI 2.07 to 3.17, p <0.001), in-hospital mortality (OR 3.46, 95{\%} CI 2.34 to 5.11, p <0.001), and bleeding complications (OR 2.36, 95{\%} CI 1.70 to 3.25, p <0.001). In subgroup analyses, similar trends were observed in both men and women, and in both patients with acute coronary syndrome and stable coronary artery disease. In conclusion, a low baseline hemoglobin is a simple and powerful predictor of poor outcomes in patients who undergo PCI.",
author = "Yohei Numasawa and Ikuko Ueda and Mitsuaki Sawano and Toshiki Kuno and Masaki Kodaira and Shigetaka Noma and Masahiro Suzuki and Hiroaki Miyata and Keiichi Fukuda and Shun Kosaka",
year = "2018",
month = "3",
day = "15",
doi = "10.1016/j.amjcard.2017.12.007",
language = "English",
volume = "121",
pages = "695--702",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Relation of Baseline Hemoglobin Level to In-Hospital Outcomes in Patients Who Undergo Percutaneous Coronary Intervention (from a Japanese Multicenter Registry)

AU - Numasawa, Yohei

AU - Ueda, Ikuko

AU - Sawano, Mitsuaki

AU - Kuno, Toshiki

AU - Kodaira, Masaki

AU - Noma, Shigetaka

AU - Suzuki, Masahiro

AU - Miyata, Hiroaki

AU - Fukuda, Keiichi

AU - Kosaka, Shun

PY - 2018/3/15

Y1 - 2018/3/15

N2 - Scarce data exist regarding the relation between baseline hemoglobin and in-hospital outcomes after percutaneous coronary intervention (PCI). We studied 13,010 cases of PCI in a Japanese multicenter registry from 2008 to 2016. Patients were divided into 5 groups according to 2-g/dl increments in their preprocedural hemoglobin (from <10 to >16 g/dl). Patients with lower hemoglobin levels were older and had higher proportions of females and co-morbidities, including diabetes mellitus and renal failure, than those with higher hemoglobin levels. In-hospital complications were observed more frequently in patients with lower than higher levels. After adjustment, baseline hemoglobin was inversely associated with total procedural complications (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.84 to 0.90, p <0.001), in-hospital mortality (OR 0.82, 95% CI 0.77 to 0.87, p <0.001), and bleeding complications (OR 0.93, 95% CI 0.88 to 0.98, p = 0.007). Categorically, reverse J-shaped curvilinear correlations were present between baseline hemoglobin and in-hospital adverse outcomes. When the reference group comprised patients with a baseline hemoglobin of 12 to 14 g/dl, patients within the lowest hemoglobin levels (<10 g/dl) were at the highest risk of total procedural complications (OR 2.57, 95% CI 2.07 to 3.17, p <0.001), in-hospital mortality (OR 3.46, 95% CI 2.34 to 5.11, p <0.001), and bleeding complications (OR 2.36, 95% CI 1.70 to 3.25, p <0.001). In subgroup analyses, similar trends were observed in both men and women, and in both patients with acute coronary syndrome and stable coronary artery disease. In conclusion, a low baseline hemoglobin is a simple and powerful predictor of poor outcomes in patients who undergo PCI.

AB - Scarce data exist regarding the relation between baseline hemoglobin and in-hospital outcomes after percutaneous coronary intervention (PCI). We studied 13,010 cases of PCI in a Japanese multicenter registry from 2008 to 2016. Patients were divided into 5 groups according to 2-g/dl increments in their preprocedural hemoglobin (from <10 to >16 g/dl). Patients with lower hemoglobin levels were older and had higher proportions of females and co-morbidities, including diabetes mellitus and renal failure, than those with higher hemoglobin levels. In-hospital complications were observed more frequently in patients with lower than higher levels. After adjustment, baseline hemoglobin was inversely associated with total procedural complications (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.84 to 0.90, p <0.001), in-hospital mortality (OR 0.82, 95% CI 0.77 to 0.87, p <0.001), and bleeding complications (OR 0.93, 95% CI 0.88 to 0.98, p = 0.007). Categorically, reverse J-shaped curvilinear correlations were present between baseline hemoglobin and in-hospital adverse outcomes. When the reference group comprised patients with a baseline hemoglobin of 12 to 14 g/dl, patients within the lowest hemoglobin levels (<10 g/dl) were at the highest risk of total procedural complications (OR 2.57, 95% CI 2.07 to 3.17, p <0.001), in-hospital mortality (OR 3.46, 95% CI 2.34 to 5.11, p <0.001), and bleeding complications (OR 2.36, 95% CI 1.70 to 3.25, p <0.001). In subgroup analyses, similar trends were observed in both men and women, and in both patients with acute coronary syndrome and stable coronary artery disease. In conclusion, a low baseline hemoglobin is a simple and powerful predictor of poor outcomes in patients who undergo PCI.

UR - http://www.scopus.com/inward/record.url?scp=85040593970&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040593970&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2017.12.007

DO - 10.1016/j.amjcard.2017.12.007

M3 - Article

C2 - 29361289

AN - SCOPUS:85040593970

VL - 121

SP - 695

EP - 702

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 6

ER -