title: In-hospital prognostic value of hemoglobin levels on admission in patients with acute ST segment elevation myocardial infarction undergoing primary angioplasty.
abstract: OBJECTIVE
  Anemia is a common comorbidity in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the in-hospital prognostic value of admission hemoglobin (Hb) levels in patients with acute STEMI undergoing primary percutaneous coronary intervention (p-PCI).
  
  
  METHODS
  This is a retrospective study of 1,625 patients with STEMI stratified by quartiles of admission Hb concentration (Q1 ≤12.5 g/dl, Q2 12.6-13.8 g/dl, Q3 13.9-15.0 g/dl, Q4 ≥15.1 g/dl). Main outcome measures were in-hospital rates of all cause mortality, re-infarction, target vessel revascularization, stroke, heart failure (HF) and bleeding complications.
  
  
  RESULTS
  The incidences of in-hospital mortality according to quartiles from Q1 to Q4 were 8.6, 3.9, 2.4 and 2.6%, respectively (p < 0.001). The incidences of major hemorrhage and HF were significantly higher in Q1, compared to the other quartiles (7.4, 1.9, 3.1, 2.8%, p < 0.001; 16.3, 8.5, 7.7, 9.8%, p < 0.001, respectively). Multiple logistic-regression analysis showed that low admission Hb level (Q1) is an independent and a potent predictor for in-hospital mortality [unadjusted odds ratio (OR): 3.84, 95% confidence interval (CI): 1.78-7.82; p < 0.001].
  
  
  CONCLUSIONS
  Lower concentrations of Hb on admission are associated with higher rates of in-hospital mortality, heart failure and major bleeding after p-PCI.
authors.affiliation: Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Dündar
authors.forename: Vecih
authors.initials: V
authors.lastname: Oduncu
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Ali Cevat
authors.initials: AC
authors.lastname: Tanalp
authors.forename: Dicle
authors.initials: D
authors.lastname: Sırma
authors.forename: Ali
authors.initials: A
authors.lastname: Karagöz
authors.forename: Can Yücel
authors.initials: CY
authors.lastname: Karabay
authors.forename: Alev
authors.initials: A
authors.lastname: Kılıçgedik
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Kürşat
authors.initials: K
authors.lastname: Tigen
authors.forename: Akın
authors.initials: A
authors.lastname: Izgi
authors.forename: Cevat
authors.initials: C
authors.lastname: Kırma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006454:Hemoglobins / Q000378:metabolism*; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins