Abstract 13183: Persistent Anemia Was Associated With Higher Long-Term Mortality in Patients With Chronic Kidney Disease Following Primary Percutaneous Coronary Intervention

Background: Anemia is one of the most common complications of chronic kidney disease (CKD), renal anemia, which has a significant link with increased risk of the morbidity, as well as the mortality of cardiovascular disease. However, the prognostic implication of the temporal change of anemia status has been rarely addressed, especially in secondary prevention of coronary artery disease (CAD). Methods and Results: This long-term (median follow-up range: 5.7 years) single center observational study involved consecutive 416 patients with CKD over stage 3 (defined by eGFR<60 ml/1.72/m 2 ) who underwent percutaneous coronary intervention (PCI) for the first time since 2003 to 2018. All-cause death was set as an endpoint. Participants were divided into 4 groups by the median of hemoglobin (Hb) at PCI (baseline, 12.0 mg/dl) and 8.1±2.1 months after PCI (follow-up, 12.7 mg/dl), respectively: Groups of Continuously high-Hb (n=146), Increased-Hb (n=51), Attenuated-Hb (n=61) and Persistently low-Hb (n=158). Categorized Cox proportional hazard analysis with setting Continuously high-Hb group as a reference showed a significantly increased risk of all-cause death in groups of Attenuated- (Hazard ratio (HR) 2.6, 95% confidence interval (CI) 1.3-5.2, p=0.01) and Persistently low-Hb (HR 2.6, 95%CI 1.4-4.8, p=0.002), respectively, while similar in Increased-Hb group (HR 1.1, 95%CI 0.3-3.2, p>0.5) (Figure) . Conclusion: This study showed a significant association between the reduced Hb overtime and increased mortality risk in patients with CKD and CAD, which might potentially indicate a prognostic merit of the intervention for renal anemia in this population.