Saratov JOURNAL of Medical and Scientific Research

Acute coronary syndrome and anemia: features of choosing the optimal medical tactics (review)

Year: 2021, volume 17 Issue: №3 Pages: 560-565
Heading: Тhematic supplement Article type: Review
Authors: Puchinyan N.F., Furman N.V., Malinova L.I., Dovgalevskiy Ya.P.
Organization: Regional Cardiology Clinic (Saratov), Saratov State Medical University

The review evaluates, according to the literature, the clinical and pathogenetic significance of anemia in patients with acute coronary syndrome (ACS). In this clinical situation, the problems of choosing the optimal therapy associated with the smallest evidence base are highlighted. For this, the results of clinical studies published in bibliographic databases: PubMed, Publons and eLibrary were analyzed (the review included 40 publications for 1989-2020). The epidemiological features of the anemia syndrome in patients with ACS are most well studied. Anemia is often circulated in ACS and is associated with an unfavorable prognosis. The question remains whether anemia plays a direct causal role in the deterioration of short- and long-term morbidity and mortality, or is it rather an indicator of a poor clinical condition. A separate study for ACS in patients with anemia, due to the minimal evidence base, requires the choice of optimal antithrombotic therapy: specific drugs and the duration of their administration.

1. Collet J-P, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2020; 00: 1-79. DOI: 10.1093/eurheartj/ehaa575.
2. Neumann F-J, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019; 40: 87-165. DOI: 10.1093/eurheartj/ehy394.
3. Meneveau N, Schiele F, Seronde MF, et al. Anemia for risk assessment of patients with acute coronary syndromes. Am J Cardiol 2009; 103: 442-7. DOI: 10.1016/j. amjcard. 2008.10.023.
4. Tsujita K, Nikolsky E, Lansky AJ, et al. Impact of anemia on clinical outcomes of patients with ST-segment elevation myocardial infarction in relation to gender and adjunctive antithrombotic therapy (from the HORIZONS-AMI trial). Am J Cardiol 2010; 105: 1385-94. DOI: 10.1016/j. amjcard. 2010.01.001.
5. Sulaiman K, Prashanth P, Al-Zakwani I, et al. Impact of anemia on in-hospital, one-month and one-year mortality in patients with acute coronary syndrome from the Middle East. Clinical Medicine & Research 2012; 10: 65-71. DOI: 10.3121/cmr. 2011.103.;
6. Kunadian V, Mehran R, Lincoff AM, et al. Effect of anemia on frequency of short- and long-term clinical events in acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial). Am J Cardiol 2014; 114: 1823-9. DOI: 10.1016/j. amjcard. 2014.09.023.
7. Yazji К, Abdul F, Elangovan S, et al. Baseline anemia in patients undergoing percutaneous coronary intervention after an acute coronary syndrome-A paradox of high bleeding risk, high ischemic risk, and complex coronary disease. J Interv Cardiol 2017;30:491-9. DOI: 10.1111 /joic. 12406.
8. Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change with Aging? Seminars in Hematology 2015; 52:261 -9. DOI: 10.1053/j. seminhematol. 2015.07.006.
9. Nutritional anaemias: Report of a WHO scientific group. World Health Organ Tech Rep Ser 1968; 405: 5-37.
10. Beutler E, Waalen J. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood 2006; 107: 1747-50. DOI: 10.1182/blood-2005-07-3046.
11. Patel KV. Variability and heritability of hemoglobin concentration: an opportunity to improve understanding of anemia in older adults. Haematologica 2008; 93: 1281-3. DOI: 10.3324/haematol. 13692.
12. Morici N, Cantoni S, Antonicelli R, et al. Anemia in octogenarians with non-ST elevation acute coronary syndrome: aging or disease? Int J Cardiol 2014; 176: 1147-9. DOI: 10.1016/j. amjcard. 2008.10.023.
13. Mancini DM, Katz SD, Lang CC, et al. Effect of erythropoietin on exercise capacity in patients with moderate to severe chronic heart failure. Circulation 2003; 107: 294-9. DOI: 10.1161/01. cir. 0000044914.42696.6a.
14. Androne AS, Katz SD, Lund L, et al. Hemodilution is common in patients with advanced heart failure. Circulation 2003; 107:226-9. DOI: 10.1161/01. cir. 0000052623.16194.80.
15. Salisbury AC, AminAP, Reid KJ, etal. Hospital-acquired anemia and in-hospital mortality in patients with acute myocardial infarction. Am Heart J 2011; 162: 300-9e3. DOI: 10.1016/j. ahj. 2011.05.021.
16. Nabais S, Gaspar A, Costa J, et al. Prognostic impact of hemoglobin drop during hospital stay in patients with acute coronary syndromes. Rev Port Cardiol 2009; 28: 383-95.
17. Hasin T, Sorkin A, Markiewicz W, et al. Prevalence and prognostic significance of transient, persistent, and new-onset anemia after acute myocardial infarction. Am J Cardiol 2009; 104: 486-91. DOI: 10.1016/j. amjcard. 2009.03.066.
18. Cash JM, Sears DA. The anemia of chronic disease: spectrum of associated diseases in a series of unselected hospitalized patients. Am J Med 1989; 87: 638-44. DOI: 10.1016/S0002-9343 (89) 80396-1.
19. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl JMed 2005; 352: 1011-23. DOI: 10.1056/NEJMra041809.
20. Nakamura Y, Ohsawa I, Goto Y, et al. The Impact of Human Parvovirus B19 Infection on Heart Failure and Anemia with Reference to Iron Metabolism Markers in an Adult Woman. Intern Med 2018; 57: 403-7. DOI: 10.2169/internalmedicine. 8809-17.
21. Bullen JJ, Rogers HJ, Spalding PB, Ward CG. Iron and infection: the heart of the matter. FEMS Immunol Med Microbiol 2005; 43: 325-30. DOI: 10.1016/j. femsim. 2004.11.010.
22. Mamas MA, KwokCS, Kontopantelis E.etal. Relationship between Anemia and Mortality Outcomes in a National Acute Coronary Syndrome Cohort: Insights from the UK Myocardial Ischemia National Audit Project Registry. JAm HeartAssoc2016; 5. DOI: 10.1161/JAHA. 116.003348.
23. Solomon A, Blum A, Peleg A, et al. Endothelial progenitor cells are suppressed in anemic patients with acute coronary syndrome. Am J Med 2012; 125: 604-11. DOI: 10.1016/j. amjmed. 2011.10.025.
24. Sudarsky D, Sudarsky M, Matezky S, et al. Impact of Early Invasive Approach on Outcomes of Patients with Acute Coronary Syndrome and Baseline Anemia: Analysis from the ACSIS Registry. J Interv Cardiol 2015; 28: 315-25. DOI: 10.1016/j. amjmed. 2011.10.025.
25. Lee SH, Jeong MH, Han KR, et al. Comparison of Transradial and Transfemoral Approaches for Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome and Anemia. Am J Cardiol 2016; 117: 1582-7. DOI: 10.1016/j. amjcard. 2016.02.030.
26. Farhan S, Baber U, Mehran R. Anemia and Acute Coronary Syndrome: Time for Intervention Studies. J Am Heart Assoc2016;5. DOI: 10.1161/JAHA. 116.004908.
27. Chen X, Zhou CH, Hong Y, Gong TX. [Expression of endothelial nitric oxide synthase mRNA in human RBCs during storage]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2013; 21: 481 -3. DOI: 10.7534/j. issn. 1009-2137.2013.02.047.
28. PawloskiJR,StamlerJS. Nitricoxide in RBCs. Transfusion 2002; 42: 1603-9. DOI: 10.1046/j. 1537-2995.2002.00278. x.
29. Zimmerman R, Tsai AG, Salazar Vazquez BY, et al. Posttransfusion Increase of Hematocrit per se Does Not Improve Circulatory Oxygen Delivery due to Increased Blood Viscosity. Anesth Analg 2017; 124: 1547-54. DOI: 10.1213/ANE. 0000000000002008.
30. Hendrickson JE, Hillyer CD. Noninfectious serious hazards of transfusion. Anesth Analg 2009; 108: 759-69. DOI: 10.1213/ane. 0b013e3181930.
31. Tsai AG, Cabrales P, Intaglietta M. Microvascular perfusion upon exchange transfusion with stored red blood cells in normovolemic anemic conditions. Transfusion 2004; 44:1626-34. DOI: 10.1111/j. 0041-1132.2004.04128. x.
32. Carson JL, Sieber F, Cook DR, et al. Liberal versus restrictive blood transfusion strategy: 3-year survival and cause of death results from the FOCUS randomised controlled trial. Lancet 2015; 385: 1183-9. DOI: 10.1016/S0140-6736 (14) 62286-8.
33. Ripolles Melchor J, Casans Frances R, Espinosa A, et al. Restrictive versus liberal transfusion strategy for red blood cell transfusion in critically ill patients and in patients with acute coronary syndrome: a systematic review, meta-analysis and trial sequential analysis. Minerva Anestesiol 2016; 82: 582-98.
34. Hoist LB, Petersen MW, Haase N, et al. Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis. BMJ 2015; 350: h1354. DOI: 10.1136/bmj. h1354.
35. Docherty AB, O'Donnell R, Brunskill S, et al. Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting: systematic review and meta-analysis. BMJ 2016; 352: И351. DOI: 10.1136/bmj. И351.
36. Chatterjee S, Wetterslev J, Sharma A, et al. Association of blood transfusion with increased mortality in myocardial infarction: a meta-analysis and diversity-adjusted study sequential analysis. JAMA Intern Med 2013; 173: 132-9. DOI: 10.1001 /2013. jamainternmed. 1001.
37. Alexander KP, Chen AY, Wang TY, et al. Transfusion practice and outcomes in non-ST-segment elevation acute coronary syndromes. Am Heart J 2008; 155: 1047-53. DOI: 10.1016/j. ahj. 2008.01.009.
38. Carson JL, Stanworth SJ, Roubinian N, et al. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev 2016; 10: CD002042. DOI: 10.1002/14651858. CD002042. pub4.
39. Ruifrok WP, Lipsic E, de Boer RA, et al. Erythropoiesis stimulation in acute ischemic syndromes. Heart Fail Clin 2010; 6: 313-21. DOI: 10.1016/j. hfc. 2009.12.002.
40. Ariotti S, Adamo M, Costa F, et al. Is Bare-Metal Stent Implantation Still Justifiable in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention?: A Pre-Specified Analysis from the ZEUS Trial. JACC Cardiovasc Interv 2016;9:426-36. DOI: 10.1016/j. jcin. 2015.11.015.

2021_03-1_560-565.pdf307.31 KB

No votes yet