Prognostic impact of baseline anemia on outcomes after elective PCI in men: A US retrospective cohort study

Authors

• Abdalhakim Shubietah, Advocate Health - MidwestFollow
• Mohamed S. Elgendy, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Mohamed Saad Rakab, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
• Ahmed Ahmed, Department of Medicine, Al-Quds University, East Jerusalem, West Bank, Palestine.
• Batoul Abusalah, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
• Mohamed R. Murad, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Belal Mohamed Hamed, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Hamza A. Abdul-Hafez, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
• Ahmed Emara, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Qutaiba Qafisheh, Department of Medicine, University of Toledo, Toledo, Ohio, USA.
• Elsayed Balbaa, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
• Ameer Awashra, Department of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
• Ahmed Mansour, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Ahmed Elbataa, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Abdalrahman Assaassa, Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
• Mohammed Mhanna, Division of Cardiovascular Medicine, University of Iowa, Iowa, USA.

Recommended Citation

Shubietah A, Elgendy MS, Rakab MS, et al. Prognostic Impact of Baseline Anemia on Outcomes After Elective PCI in Men: A US Retrospective Cohort Study. Catheter Cardiovasc Interv. Published online April 2, 2026. doi:10.1002/ccd.70583

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: It is unclear whether preprocedural anemia independently affects outcomes after elective PCI in men with stable CAD.

Methods: Using the TriNetX US Collaborative Network, we identified adult men undergoing first-time elective PCI (2016-2024) and compared those with hemoglobin < 13 g/dL (1-7 days pre-PCI) to non-anemic controls. Propensity-score matching produced two balanced cohorts (n = 1424). Outcomes at 7 days, 30 days, 6 months, and 12 months were analyzed with univariate and multivariable Cox models. Residual confounding was assessed with falsification endpoints and E-values, and multiplicity with Bonferroni and Benjamini-Hochberg adjustments.

Results: After propensity-score matching, 7-day outcomes were similar between groups. At 30 days, anemia was associated with higher risks of AKI (HR 1.92; 95% CI 1.35-2.72) and major bleeding (HR 2.49; 95% CI 1.48-4.19); however, the 30-day association with all-cause hospitalization (HR 1.32; 95% CI 1.05-1.66) did not remain statistically significant after multiplicity adjustment. At 6 months, anemia was linked to higher risks of AKI (HR 2.34; 95% CI 1.84-2.97), mortality (HR 2.63; 95% CI 1.63-4.26), hospitalization (HR 1.56; 95% CI 1.34-1.80), major bleeding (HR 3.28; 95% CI 2.34-4.61), and transfusion (HR 5.47; 95% CI 3.31-9.06); the association with MACE (HR 1.37; 95% CI 1.10-1.70) was sensitive to multiplicity adjustment (significant under false-discovery-rate control but not Bonferroni). At 12 months, anemia remained associated with higher risks of AKI (HR 1.96; 95% CI 1.60-2.41), mortality (HR 1.88; 95% CI 1.31-2.70), hospitalization (HR 1.41; 95% CI 1.23-1.62), major bleeding (HR 2.16; 95% CI 1.66-2.81), and transfusion (HR 3.35; 95% CI 2.31-4.85); the association with MACE (HR 1.26; 95% CI 1.03-1.53) did not persist after multiplicity adjustment. Each 1 g/dL increase in hemoglobin was associated with lower risks of AKI and transfusion in univariate Cox models, with similar directionality after adjustment.

Conclusions: In men undergoing first-time elective PCI for stable CAD, baseline anemia was associated with higher 12-month risks of AKI, major bleeding, transfusion, hospitalization, and death-especially with recent (≤ 1 year) bleeding or transfusion.

Type

Article

PubMed ID

41928374