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- 저자 : ( Pen Chih Liao ) (검색결과 1 건)
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( Cheng Wei Liu ),( Yi Ching Lin ),( Chung Ming Tu ),( Pen Chih Liao ),( Kuan Change Chen ),( Yen Wen Wu ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Anemia is associated with poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI). However, it is unclear that erythrocytosis has protective effect in these populations. Hence, we conducted a retrospective cohort study to examine the relationship between erythrocytosis and mortality in patients with STEMI undergoing primary percutaneous coronary intervention (PCI ). Materials and Methods: We screened 1,156 consecutive patients with STEMI undergoing primary PCI in a single center during Feb 2007 and January 2012. There were 201 missing data for door-to-balloon time and 4 missing data for hemoglobin. Of 951 analyzable patients, they were divided into anemia (Hemoglobin<13.0mg/dl in men or <12.0mg/dl in women), normal hemoglobin, and erythrocytosis (hemoglobin =16.0mg/dl in men or =15.0mg/dl in women) groups. The study end point was one-year mortality. Results: There were 148, 535, and 268 patients in anemia, normal hemoglobin, and erythrocytosis groups, respectively. Patients in the anemia group were older and had lower body mass index than other two groups. There was more female, smokers, hypertension, and diabetes in the anemia group. One-year mortality rates were 16.2%, 6.5%, 2.6% (P<0.001) respectively. In univariate proportional hazards regression analysis, age, hemoglobin, total cholesterol, statin use, glycoprotein llb/llla inhibitor use, and TIMI risk score were associated with 1-year mortality in three groups. After adjustment for potential confounders, hemoglobin levels remained an independent predictor of one-year mortality in both anemia (hazard ratio 0.697, 95% CI 0.528-0.960) and erythrocytosis group (hazard ratio 3.129, 95% CI 1.1.474-6.642). Conclusions: Patients with STEMI and anemia had the worst outcomes than normal hemoglobin and erythrocytosis groups. Expectedly, hemoglobin had the protective effect on prognosis in anemia group. However, a hemoglobin level was an independent risk factor of one-year mortality in those with erythrocytosis.
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