title: Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: analysis from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Trial.
abstract: OBJECTIVE
  We sought to investigate the impact of anemia in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  The prognostic importance of anemia on primary PCI outcomes is unknown.
  
  
  METHODS
  In the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial, 2,082 patients of any age with AMI within 12 h onset undergoing primary PCI were randomized to balloon angioplasty versus stenting, each +/- abciximab. Outcomes were stratified by the presence of anemia at baseline, as defined by World Health Organization criteria (hematocrit <39% for men and <36% for women).
  
  
  RESULTS
  Anemia was present in 260 (12.8%) of 2,027 randomized patients with baseline laboratory values. Patients with versus without baseline anemia more frequently developed in-hospital hemorrhagic complications (6.2% vs. 2.4%, p = 0.002), had higher rates of blood product transfusions (13.1% vs. 3.1%, p < 0.0001), and had a prolonged (median 4.1 vs. 3.5 days, p < 0.0001) and more expensive (median costs $12,434 vs. $11,603, p = 0.002) index hospitalization. Patients with versus without anemia had strikingly higher mortality during hospitalization (4.6% vs. 1.1%, p = 0.0003), at 30 days (5.8% vs. 1.5%, p < 0.0001), and at 1 year (9.4% vs. 3.5%, p < 0.0001). The rates of disabling stroke at 30 days (0.8% vs. 0.1%, p = 0.005) and at 1 year (2.1% vs. 0.4%, p = 0.0007) were also significantly higher in patients with anemia. By multivariate analysis, anemia was an independent predictor of in-hospital mortality (hazard ratio, 3.26; p = 0.048) and one-year mortality (hazard ratio, 2.38; p = 0.016).
  
  
  CONCLUSIONS
  Anemia at baseline in patients with AMI undergoing primary PCI is common, and is strongly associated with adverse outcomes and increased mortality.
authors.affiliation: Cardiovascular Research Foundation, New York, New York 10022, USA.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nikolsky
authors.forename: Eve D
authors.initials: ED
authors.lastname: Aymong
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Grines
authors.forename: David A
authors.initials: DA
authors.lastname: Cox
authors.forename: Eulogio
authors.initials: E
authors.lastname: Garcia
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: James E
authors.initials: JE
authors.lastname: Tcheng
authors.forename: John J
authors.initials: JJ
authors.lastname: Griffin
authors.forename: Giulio
authors.initials: G
authors.lastname: Guagliumi
authors.forename: Thomas
authors.initials: T
authors.lastname: Stuckey
authors.forename: Mark
authors.initials: M
authors.lastname: Turco
authors.forename: David A
authors.initials: DA
authors.lastname: Cohen
authors.forename: Manuela
authors.initials: M
authors.lastname: Negoita
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000077284:Abciximab; D000368:Aged; D000740:Anemia / Q000150:complications*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D016913:Blood Component Transfusion / Q000706:statistics & numerical data; D005260:Female; D006400:Hematocrit; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D017052:Hospital Mortality; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab