title: Prognostic value of admission hemoglobin levels in ST-segment elevation myocardial infarction patients presenting with cardiogenic shock.
abstract: Even in the era of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS), mortality remains high. Whether admission hemoglobin (Hb) concentration is a predictor of mortality in patients with CS treated with primary PCI is unexplored. We assessed the relation between admission Hb concentration and 1-year mortality in patients with STEMI and CS who were treated with PCI at admission. We investigated a cohort of 265 patients with STEMI with CS on admission. Patients were categorized in 3 groups according to plasma Hb levels at admission: 9.6 g/dl (group I, n = 22), 9.6 to 12 g/dl (group II, n = 59), and >12 g/dl (group III, n = 184). All-cause mortality at 1 year was 64%, 46%, and 35% for groups I, II, and III, respectively (p = 0.007). Multivariate logistic regression analysis showed that the odds for mortality increased 17% for every 1.0 g/dl decrease in plasma Hb (odds ratio 1.17, 95% confidence interval 1.01 to 1.35, p = 0.042). In conclusion, admission Hb concentration is an independent predictor for 1-year mortality in patients with STEMI undergoing primary PCI.
authors.affiliation: Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: M Marije
authors.initials: MM
authors.lastname: Vis
authors.forename: Krischan D
authors.initials: KD
authors.lastname: Sjauw
authors.forename: René J
authors.initials: RJ
authors.lastname: van der Schaaf
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D012770:Shock, Cardiogenic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors
chemical_list: D006454:Hemoglobins