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Shedding blood: anemia and adverse events after percutaneous coronary intervention (PCI).

Substantial evidence from epidemiological studies suggests strong association between baseline anemia and worse outcomes following percutaneous coronary intervention (PCI) for both stable coronary artery disease (CAD) and acute coronary syndromes (ACS) (1-3). The existing data, almost exclusively from prospective analysis of clinical cohorts or retrospective post-hoc analysis of data from large randomized clinical trials designed to investigate other specific endpoints, point to anemia as a strong independent predictor of major adverse cardiac outcomes (MACE), major bleeding and mortality in patients undergoing PCI (4-6). Some of the published studies have utilized rigorous statistical methods to adjust for all known and measurable variables that can interact with anemia, nevertheless the associations inferred from these studies, while providing valuable insights, remain hypothesis generating.