Mild haemoglobin drop and clinical outcomes in acute coronary syndrome patients: finding from the BleeMACS registry
Ze-Kun ZHANG1
Yan YAN1
Si-Yi LI1
Sergio Raposeiras-Roubín2
Emad Abu-Assi2
José P.Henriques3
Fabrizio D'Ascenzo4
Jorge Saucedo5
Wei GONG1
Shao-Ping NIE1
1.Center for Coronary Artery Disease,Division of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,China;National Clinical Research Center for Cardiovascular Diseases,Beijing,China;Beijing Institute of Heart,Lung,and Blood Vessel Diseases,Beijing,China2.Department of Cardiology,álvaro Cunqueiro University Hospital,Vigo,Spain3.Department of Cardiology,Amsterdam University Medical Center,Amsterdam,the Netherlands4.Division of Cardio-logy,Department of Medical Science,University of Turin,Turin,Italy5.Division of Cardiovascular Medicine,Medical Co-llege of Wisconsin,Wisconsin,USA
摘要：BACKGROUND Haemoglobin drop is common in acute coronary syndrome (ACS) patients and correlates with poor prognosis. However, the association between mild haemoglobin drop and adverse clinical outcome remains insufficiently investigated. This study aimed to examine the association between in-hospital haemoglobin drop and risk for adverse clinical outcomes in ACS pa-tients, especially those with mild drop.METHODS Included patients from the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged af-ter an Acute Coronary Syndrome) registry were categorized into three groups by the presence and amount of in-hospital haemog-lobin drop (non-drop, mild drop and severe drop). The cut-off point between mild drop and severe drop is ≥ 3 g/dL. Multivariate Cox regression was used to assess the association between haemoglobin drop and major adverse cardiac endpoints (MACE). Pa-tients taking potent P2Y12 inhibitors were selected for the additional analysis. Propensity score matching was used to avoid select-ive bias in the additional analysis. RESULTS Of 6911 patients, 4949 patients (71.6％) experienced in-hospital haemoglobin drop. Compare with non-drop group, pa-tients with haemoglobin drop had higher risk of MACE [adjusted hazard ratio (HR) = 1.36, 95％ CI: 1.03–1.80 for mild drop group;adjusted HR = 1.70, 95％ CI: 1.07–2.68 for severe drop group]. Patients in mild drop group were less likely to receive potent P2Y12 inh-ibitors at discharge (mild drop group vs. severe drop group vs. non-drop group: 10.9％ vs. 10.7％ vs. 23.8％). After propensity score matching adjustment among patients with potent P2Y12 inhibitors, patients in mild drop group were not associated with an incr-eased risk of MACE than those in non-drop group (adjusted HR = 1.52, 95％ CI: 0.49–4.72). CONCLUSIONS In-hospital haemoglobin drop was common in ACS patients and associated with a higher risk for adverse eve-nts. Reduced prescription for potent P2Y12 inhibitors may be responsible for poor prognoses among patients with mild haemog-lobin drop.
机标关键词：registryclinicalmilddropfromacutebleemacscoronary
论文发表日期：2022-12-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 981-989 )