Journal ArticleDOI
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)
Kenichi Tsujita,Eugenia Nikolsky,Alexandra J. Lansky,George Dangas,Martin Fahy,Bruce R. Brodie,Dariusz Dudek,Martin Möckel,Andrzej Ochała,Roxana Mehran,Gregg W. Stone +10 more
TLDR
In this paper, the impact of baseline anemia on the outcomes of patients with ST elevation myocardial infarctions who underwent primary percutaneous coronary intervention in relation to contemporary adjunctive antithrombotic therapy and gender was assessed at 30 and 1 year according to anemia and gender.Abstract:
The aim of this study was to assess the impact of baseline anemia on the outcomes of patients with ST elevation myocardial infarctions who underwent primary percutaneous coronary intervention in relation to contemporary adjunctive antithrombotic therapy and gender. In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, patients were randomized to bivalirudin alone or to unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor before primary percutaneous coronary intervention. Outcomes were assessed at 30 days and 1 year according to anemia and gender. Baseline anemia was present in 331 of 3,153 patients (10.5%). Patients with versus without baseline anemia had a more than twofold increase in major bleeding at 30 days (13.5% vs 6.7%, p <0.0001) and at 1 year (14.8% vs 7.2%, p <0.0001), an association that on multivariate analysis was independent of gender. Mortality was significantly higher in men with versus without baseline anemia (4.6% vs 1.8% at 30 days, p = 0.003; 8.9% vs 3.0% at 1 year, p <0.0001) but not in women (5.3% vs 3.6% at 30 days, p = 0.42; 7.5% vs 5.9% at 1 year, p = 0.54). On multivariate analysis, anemia independently predicted 1-year all-cause mortality in men but not in women. Bivalirudin compared with unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor resulted in twofold lower rates of all-cause and cardiac mortality and major bleeding in patients without but not in those with baseline anemia. In conclusion, baseline anemia was associated with increased major bleeding and death in patients with ST elevation myocardial infarctions who underwent primary PCI but was a stronger predictor of early and late mortality in men than in women. Paradoxically, in this post hoc analysis, the reductions in major bleeding and mortality in ST elevation myocardial infarction afforded by bivalirudin occurred primarily in patients without baseline anemia.read more
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Journal ArticleDOI
Diagnostic blood loss from phlebotomy and hospital-acquired anemia during acute myocardial infarction.
Adam C. Salisbury,Kimberly J. Reid,Karen P. Alexander,Frederick A. Masoudi,Sue-Min Lai,Paul S. Chan,Richard G. Bach,Tracy Y. Wang,John A. Spertus,Mikhail Kosiborod +9 more
TL;DR: Blood loss from greater use of phlebotomy is independently associated with the development of hospital-acquired anemia during acute myocardial infarction, suggesting that HAA may be preventable by implementing strategies to limit blood loss from laboratory testing.
Journal ArticleDOI
Anemia and mortality in acute coronary syndromes: A systematic review and meta-analysis
Patrick R. Lawler,Kristian B. Filion,Tara Dourian,Renée Atallah,Michael Garfinkle,Mark J. Eisenberg +5 more
TL;DR: Clinically and statistically significant increases in mortality were observed as early as at 30 days post-ACS and persisted at 1 year and anemia in patients with ACS is independently associated with a significantly increased risk of early and late mortality.
Journal ArticleDOI
Iron deficiency anemia--bridging the knowledge and practice gap.
Aryeh Shander,Aryeh Shander,Lawrence T. Goodnough,Mazyar Javidroozi,Michael Auerbach,Jeffrey L. Carson,William B. Ershler,Mary Ghiglione,John A. Glaspy,Indu Lew +9 more
TL;DR: An algorithm for detection and management of anemia was discussed, which incorporated iron study (with primary emphasis on transferrin saturation), serum creatinine and glomerular filtration rate, and vitamin B12 and folic acid measurements, and management strategies included iron therapy, erythropoiesis-stimulating agents, and referral as needed.
Journal ArticleDOI
Hospital-acquired anemia and in-hospital mortality in patients with acute myocardial infarction
Adam C. Salisbury,Amit P. Amin,Kimberly J. Reid,Tracy Y. Wang,Frederick A. Masoudi,Paul Chan,Karen P. Alexander,Richard G. Bach,John A. Spertus,Mikhail Kosiborod +9 more
TL;DR: Moderate and severe HAAs are independently associated with higher in-hospital mortality during acute myocardial infarction and increased with HAA severity.
Journal ArticleDOI
The Impact of Anemia on Long-Term Clinical Outcome in Patients Undergoing Revascularization With the Unrestricted Use of Drug-Eluting Stents
Thomas Pilgrim,Florian Vetterli,Bindu Kalesan,Giulio G. Stefanini,Lorenz Räber,Stefan Stortecky,Steffen Gloekler,Ronald K. Binder,Peter Wenaweser,Aris Moschovitis,Ahmed A. Khattab,Lutz Buellesfeld,Marcel Zwahlen,Bernhard Meier,Peter Jüni,Stephan Windecker +15 more
TL;DR: Severe anemia is common among patients undergoing percutaneous coronary intervention with the unrestricted use of DES and adversely affects long-term prognosis, including survival.
References
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Journal ArticleDOI
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Journal ArticleDOI
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