Anemia, Hemorrhage, and Transfusion in Percutaneous Coronary Intervention, Acute Coronary Syndromes, and ST-Segment Elevation Myocardial Infarction

Willis, Patrick; Voeltz, Michele

doi:10.1016/j.amjcard.2009.06.013

Cited by 48 publications

(34 citation statements)

References 21 publications

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“…It is reported to have a prevalence of 5-10% in patients with NSTEMI ACS [21], of 43% in elderly STEMI patients [22] and of 12.8% in acute myocardial infarction (AMI) [4]. In The impact of anemia on mortality in AMI patients is still under debate [24,25]. In a study [2] involving 39,922 ACS patients, anemia is a powerful and independent predictor of major cardiovascular events in a 30-day followup, especially in STEMI patients.…”

Section: Discussionmentioning

confidence: 99%

Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

et al. 2010

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The present investigation, performed in 1,122 consecutive STEMI patients treated with primary coronary intervention, was aimed at evaluating: (1) the prevalence of prior anemia and its prognostic significance in the short term; and (2) the prevalence of new anemia and its impact in the short term. The prevalence of prior anemia was 27.4%. Patients with a prior anemia were older and exhibited a higher incidence of chronic diseases and comorbidities. They showed a higher intra-hospital mortality rate (p \ 0.001), a higher incidence of PCI failure (p \ 0.001) and major bleedings (p \ 0.001). Prior anemia was an independent predictor for intra-hospital mortality (OR 2.12; 95% CI 1.21-3.70, p = 0.009). Patients with a new anemia account for 46.8% of our series, and showed a higher early mortality rate and incidence of major bleedings in respect to those who maintained normal Hb values (p \ 0.05 and \0.05, respectively). our data strengthens the prognostic role of Hb values in STEMI patients submitted to primary PCI, since the presence of prior anemia identified a subset of patients, characterized by advanced age, higher comorbidities and serious coronary artery disease, at higher risk for intra ICCU mortality and complications. Moreover, the development of anemia during an ICCU stay is common, and is associated with a higher mortality rate and incidence of complications in respect to patients who maintain normal Hb values.

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Section: Discussionmentioning

confidence: 99%

Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

et al. 2010

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“…Patients with ST−elevation myocardial infarction (STEMI) very frequently require potent adjunctive antithrombotic therapy, including glycoprotein IIb/IIIa inhibitors and hence, are especially at risk for access site related bleeding complications [11]. Recent studies has further indicated that transradial approach is safe and efficacious for elective coronary angiographic studies of outpatients [12], elective left main coronary intervention [13].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous use of Mephedrone and Alcohol: A Qualitative Study of Users’ Experiences

O’Neill¹

2013

J Addict Res Ther

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IntroductionPercutaneous coronary intervention (PCI) is an integral part of treatment for ischemic heart disease. Coupled with evidence-based pharmacological strategies, the use of PCI in appropriate patients reduces morbidity and mortality across the spectrum of risk [1]. Continual evolution of antithrombotic therapy and device technology has resulted in the application of PCI to a wider population of patients [2]. Procedural success rates are high and ischemic complications relatively rare [3], thus, attention has turned to periprocedural bleeding complications [4].Bleeding events and the consequent need for transfusion are independent determinants of survival in acute coronary syndromes. Their relation to short-and long-term mortality has been demonstrated in major randomized trials as well as through the evaluation of registries.[5-8] Clinical trials evaluating new pharmacological strategies have focused on reducing this risk [9,10]; however, absolute reductions in bleeding risk have been modest across most studies. A growing body of evidence suggests that a procedural strategy-using the transradial rather than the transfemoral approach for PCI-is associated with comparatively larger reductions in bleeding complications than those achieved with any anticogulant strategy.Patients with ST−elevation myocardial infarction (STEMI) very frequently require potent adjunctive antithrombotic therapy, including glycoprotein IIb/IIIa inhibitors and hence, are especially at risk for access site related bleeding complications [11]. Recent studies has further indicated that transradial approach is safe and efficacious for elective coronary angiographic studies of outpatients [12], elective left main coronary intervention [13]. So currently, the transfemoral and transradial approach are the most popular vascular access routes for PCI worldwide. While the safety and efficacy of the transfemoral approach for acute myocardial infarction (AMI) patients undergoing primary PCI have been extensively discussed [14,15], relevant issues for using the transradial approach for primary PCI have not been fully investigated [16] in an era when transradial approach for primary PCI is already daily practice in some medical centers [17,18]. A lot of Abstract Background: Transradial approach has been used widely around the world for its unique advantages, but its use for primary percutaneous coronary intervention (pPCI) remains controversy. This study was conducted to explore the difference of major adverse cardiovascular and cerebral events (MACCE) and bleeding complications between transradial and transfemoral approach for pPCI in patients with ST−elevation myocardial infarction (STEMI).

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“…Anemia is a common comorbidity among patients with ACS, 14 and its prevalence is expected to increase due to the aging of the population. Anemia is associated with higher risk for both bleeding and ischemic complications in patients with ACS.…”

Section: Introductionmentioning

confidence: 99%

Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?

Garay

Arizá-Solé

Formiga

et al. 2016

Revista Portuguesa de Cardiologia

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Anemia, Hemorrhage, and Transfusion in Percutaneous Coronary Intervention, Acute Coronary Syndromes, and ST-Segment Elevation Myocardial Infarction

Cited by 48 publications

References 21 publications

Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

Prior and new onset anemia in ST-elevation myocardial infarction: a different prognostic role?

Simultaneous use of Mephedrone and Alcohol: A Qualitative Study of Users’ Experiences

Does anemia affect the predictive ability of bleeding risk scores in patients with acute coronary syndromes?

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