Prognostic implication of macrocytosis on adverse outcomes after coronary intervention
Prognostic implication of macrocytosis on adverse outcomes after coronary intervention
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DOI：
10.1016/j.atherosclerosis.2011.11.044
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发表时间：
2012-03-01
期刊：
影响因子：
5.3
通讯作者：
Nagai, Ryozo
中科院分区：
文献类型：
--
作者：
Myojo, Masahiro;Iwata, Hiroshi;Nagai, Ryozo
工作背景：作为红细胞的定性异常，大红细胞症作为PCI后的预后指标尚未引起关注，而作为红细胞的定量异常，贫血已被认为是不良结局的预测因子。本研究的目的是进行预后风险分层的患者PCI后的存在或不存在的macrocytosis.Methods：941例连续接受PCI在一个单一的机构的临床记录进行了回顾性分析。结果：130例（13.8%）巨红细胞症患者中有130例（13.8%）发生巨红细胞症，其中11例发生巨红细胞症，1例发生巨红细胞症。在Macrocytic组中观察到全因和心源性死亡率以及复合不良事件的发生率显著较高。Kaplan-Meier分析还显示，大红细胞症患者的总生存率明显较差。即使在排除贫血患者后，仍观察到这种趋势。此外，大红细胞症与PCI术后不良结局显著且独立相关（心源性死亡的aHR：3.45，95%CI：1.22-9.80，P = 0.019）。有趣的是，较少的患者与巨红细胞症规定他汀类药物相比，没有它（33.8%比47.1%，P = 0.005）。结论：研究结果表明，测量平均红细胞体积（MCV）作为红细胞的定性指标可能是有帮助的患者接受PCI的预后风险分层。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Background: Macrocytosis, as a qualitative abnormality of erythrocytes, has not drawn attention as a prognostic indicator after PCI, while anemia, as a quantitative abnormality of erythrocytes, has been recognized as a predictor of adverse outcomes. The aim of this study was to perform prognostic risk stratification of patients after PCI based on the presence or absence of macrocytosis.Methods: The clinical records of 941 consecutive patients who underwent PCI at a single institution were retrospectively reviewed. The prognostic implication of macrocytosis was evaluated by univariate and multivariate Cox's proportional hazard regression analysis.Results: There were 130 (13.8%) patients with macrocytosis. A significantly higher all-cause and cardiac mortality, as well as incidence of composite adverse events were observed in the Macrocytic group. Kaplan-Meier analysis also showed a significantly poorer overall survival in patients with macrocytosis. Even after exclusion of anemic patients, this tendency was still observed. Furthermore, macrocytosis was significantly and independently associated with adverse outcomes after PCI (aHR of cardiac death: 3.45, 95%CI: 1.22-9.80, P = 0.019). Interestingly, fewer patients with macrocytosis were prescribed statins compared with those without it (33.8% vs. 47.1%, P = 0.005).Conclusions: The results of the study indicate that measuring mean corpuscular volume (MCV) as a qualitative index of erythrocytes might be helpful for a prognostic risk stratification of patients subjected to PCI. (C) 2011 Elsevier Ireland Ltd. All rights reserved.