Can hemoglobin levels predict clot or bleeding risk after percutaneous coronary intervention?

This study investigated if hemoglobin (Hb) levels can predict clotting or bleeding risk (CR/BR) after a percutaneous coronary intervention (PCI). They found that lower Hb was associated with higher CR/BR after PCI.

Coronary artery disease (CAD) is caused by reduced blood flow to the heart. Surgical procedures can be used to remove blockages in the coronary arteries. Percutaneous coronary intervention (PCI) is one of these surgical procedures. A stent is usually inserted during PCI. The stent keeps the artery open to maintain blood flow. 

Patients with CAD can have repeat blockages. It is important to understand what factors may affect this risk. Hemoglobin (Hb) is a compound found in the blood. It is made up of iron molecules. Hb is present in red blood cells and carries oxygen around the body. Low Hb levels indicate that a person has anemia. Some studies suggest that anemia may increase the risk of clotting or bleeding (CR/BR). It is unclear if Hb levels before PCI can predict CR/BR after the procedure. 

This study included 19,288 patients that underwent PCI. These patients were part of 3 main studies. This study analyzed PCI outcomes. CR was assessed by heart attack and stroke rates. BR was also assessed. Hb levels before PCI were analyzed. Anemia was classified according to standard criteria. Hb levels below 13 and 12 g/dl (men and women, respectively) were considered anemic. 

33.3% of patients had anemia. Most patients had mild to moderate anemia. Patients with lower Hb tended to be older and have higher body mass index (BMI). They were also more likely to have other medical conditions.

The risk of heart attack or stroke was higher in patients with low Hb. The risk of CR/BR was increasingly higher in patients with decreasing levels of Hb. Mortality risk was associated with lower Hb levels. The risk associated with lower Hb was greater in men than in women. 

The authors concluded that lower Hb levels were associated with higher CR/BR after PCI.

The cause of anemia in this study was unknown. Some patient data was not available. More studies are needed. 

If you have any concerns regarding CAD management and anemia please consult with your physician.