Document Detail


Impact of drug-eluting versus bare-metal stents on mortality in patients with anemia.
MedLine Citation:
PMID:  19463445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our aim was to assess the incidence of all-cause mortality in patients with anemia undergoing percutaneous coronary intervention (PCI) receiving drug-eluting stents (DES) or bare-metal stents (BMS).
BACKGROUND: Anemia has been associated with poor clinical outcomes in patients undergoing PCI. However, it is unknown whether stent selection (DES or BMS) has a differential outcome in this high-risk group.
METHODS: Anemia was defined as a hematocrit below 36% for female subjects and below 40% for male subjects as defined by the World Health Organization. All patients undergoing PCI with DES or BMS alone from March 2003 to June 2007 were included. The primary end point was all-cause mortality. Anemia was further characterized using mean corpuscular volume as microcytic, normocytic, or macrocytic.
RESULTS: A total 11,181 patients underwent PCI over a 4.5-year interval; of these, 2,172 met our inclusion criteria. There were a total of 429 deaths. The majority of patients had normocytic anemia (n = 1,931). Of the 3 anemia subtypes, macrocytic anemia (DES 26%, BMS 44%) had the highest mortality followed by normocytic (DES 17%, BMS 25%) and microcytic (DES 13%, BMS 18%) anemia, respectively. All-cause mortality was significantly lower with DES in unadjusted and multivariable adjusted Cox proportional models (adjusted hazard ratio: 0.66, 95% confidence interval: 0.54 to 0.82; p < 0.001).
CONCLUSIONS: In an adjusted analysis, the use of DES as compared with the use of BMS was associated with decreased mortality in patients with anemia. Additionally, among anemia subtypes, macrocytic anemia had the highest mortality.
Authors:
Mehdi H Shishehbor; Steven J Filby; Adnan K Chhatriwalla; Ryan D Christofferson; Anil Jain; Samir R Kapadia; A Michael Lincoff; Deepak L Bhatt; Stephen G Ellis
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  2     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-08-03     Revised Date:  2013-02-21    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-36     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195-0002, USA. shishem@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Anemia / blood,  complications,  mortality*
Anemia, Macrocytic / blood,  complications,  mortality
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality*
Coronary Artery Disease / complications,  mortality*,  therapy*
Drug-Eluting Stents*
Erythrocyte Indices
Female
Hematocrit
Humans
Kaplan-Meier Estimate
Male
Metals*
Middle Aged
Proportional Hazards Models
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Stents*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
KL2 RR024990/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2009 Apr;2(4):337-8   [PMID:  19463446 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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