Comparison of New Mayo Clinic Risk Score (NMCRS) in Patients with and without Anemia Post Percutaneous Coronary Intervention (PCI): Study in Indonesia
Background: Ischemic heart disease (IHD) is the leading cause of death worldwide based on WHO. PCI is the most
common management used to treat IHD. The result of PCI for STEMI and NSTEMI management is satisfying. The prevalence
of complication of PCI, however, was 17.2% for mortality and 42% for Major Adverse Cardiovascular Events (MACE). There
are several risk-stratification score that is employed to predict the outcome of patients undergoing PCI. NMCRS is one of the
most well-known scoring system worldwide. Anemia is prevalent among patients diagnosed with ACS. Previous studies had
shown that anemia was independently associated with adverse outcome after PCI. Therefore, the objective of this study is to
evaluate the association of anemia with NCMRS scoring system as predictor of in-hospital mortality and MACE after PCI.
Methods: The design of this study is a cross-sectional study. Between August 1st, 2013 and August 31st, 2014, 119 patients
diagnosed with acute coronary syndrome (ACS) from CiptoMangunkusumo Hospital– supspecialistic-level hospital and
center of national referral – met our inclusion and exclusion criteria. For statistical analysis, Mann-Whitney test was used to
evaluate the NMCRS mortality and MACE score difference between two groups. Results: There were 119 subjects included in
this study. The median age of the subjects was 59 years (33 – 82). Among all subjects, 81.5% were male and 18.5% were
female. The number of patients diagnosed with anemia was 36.1%. Among these patients, 26.1% patient was diagnosed with
UAP, 31.1% was diagnosed with NSTEMI, and 42.9% was diagnosed with STEMI. The NMCRS mortality and MACE score
were higher significantly in patients with anemia compared to without anemia with a p-value of 0.002 and 0.001 consecutively.
Conclusion: In conclusion, anemia is associated with increase both NMCRS score in mortality and MACE which possibly
correlated with incidence of actual in-hospital mortality and MACE rate. Our study emphasized the importance of anemia as
risk predictor and suggest the inclusion of hemoglobin parameter in the risk-stratification for PCI.
Keywords - Acute coronary syndrome, anemia, New Mayo Clinic risk score, percutaneous coronary intervention