The impact of hematocrit drop on long-term survival after cardiac catheterization: insights from the Dartmouth Dynamic Registry

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Calvin C LeungDartmouth Dynamic Registry Investigators

Abstract

The long-term prognostic implication of post-procedural hematocrit drops in patients undergoing cardiac catheterization outside the clinical trial setting is not well defined. Data was prospectively collected from 12,661 patients undergoing diagnostic or interventional cardiac catheterization between July 1998 and July 2006. Patients were divided into three cohorts based upon the degree of hematocrit change: drop greater than 6, drop between 3 and 6, and drop less than 3. In-hospital major adverse events, 30-day mortality, and long-term all-cause mortality were recorded. Patients with larger reductions in hematocrit were more likely to be older, female, and have a higher baseline hematocrit, present with acute myocardial infarction, develop cardiogenic shock, require emergent catheterization, develop retroperitoneal bleeds and large hematomas, receive transfusions, have longer index hospitalizations, develop subacute stent thrombosis, and have higher 30-day and long-term mortality. An increase in long-term mortality was observed with progressive hematocrit drop. This finding is largely driven by early (30 day) mortality, as trends were no longer significant after rezeroing mortality. Hematocrit drop was not an independent risk ...Continue Reading

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