Clinical, Haemodynamic, Rheological, and Biochemical Findings in 126 Patients with Intermittent Claudication

Dormandy, J. A.; Hoare, E M; Colley, J.; Arrowsmith, D. E.; Dormandy, T. L.

doi:10.1136/bmj.4.5892.576

Cited by 250 publications

(65 citation statements)

References 21 publications

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“…This, in turn, can increase coronary vascular resistance and decrease coronary blood flow, 35 predispose to thrombosis, 36 and increase myocardial work. 37 Potential limitations of this study should be considered. The present study population was derived from clinical trials rather than unselected community cohorts; however, the inclusion and exclusion criteria differed between these 16 trials, thus potentially strengthening the generalizability of our findings.…”

Section: Discussionmentioning

confidence: 99%

Association of Hemoglobin Levels With Clinical Outcomes in Acute Coronary Syndromes

et al. 2005

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Background— In the setting of an acute coronary syndrome (ACS), anemia has the potential to worsen myocardial ischemia; however, data relating anemia to clinical outcomes in ACS remain limited. Methods and Results— We examined the association between baseline hemoglobin values and major adverse cardiovascular events through 30 days in 39 922 patients enrolled in clinical trials of ACS. After adjustment for differences in baseline characteristics and index hospitalization treatments, a reverse J-shaped relationship between baseline hemoglobin values and major adverse cardiovascular events was observed. In patients with ST-elevation myocardial infarction, when those with hemoglobin values between 14 and 15 g/dL were used as the reference, cardiovascular mortality increased as hemoglobin levels fell below 14 g/dL, with an adjusted OR of 1.21 (95% CI 1.12 to 1.30, P <0.001) for each 1-g/dL decrement in hemoglobin. At the other end of the range of hemoglobin, patients with hemoglobin values >17 g/dL also had excess mortality (OR 1.79, 95% CI 1.18 to 2.71, P =0.007). In patients with non–ST-elevation ACS, with those with hemoglobin 15 to 16 g/dL used as the reference, the likelihood of cardiovascular death, myocardial infarction, or recurrent ischemia increased as the hemoglobin fell below 11 g/dL, with an adjusted OR of 1.45 (95% CI 1.33 to 1.58, P <0.001) for each 1 g/dL decrement in hemoglobin. Patients with hemoglobin values >16 g/dL also had an increased rate of death or ischemic events (OR 1.31, 95% CI 1.03 to 1.66, P =0.027). Conclusions— Anemia is a powerful and independent predictor of major adverse cardiovascular events in patients across the spectrum of ACS.

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Section: Discussionmentioning

confidence: 99%

Association of Hemoglobin Levels With Clinical Outcomes in Acute Coronary Syndromes

et al. 2005

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“…6,7 Links between anemia and inflammation, or similar, likely synergistic impact of leukocytosis or erythrocytosis on pathophysiological mechanisms associated with adverse clinical course of ACS suggest that there is a potential interaction between WBC count and Hb and outcomes of ACS. [3][4][5][6][7][8][9][10] Despite this, the relationship of leukocytosis and Hb concentration has not been examined in the clinical setting.…”

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confidence: 99%

Hemoglobin, Leukocytosis and Clinical Outcomes of ST-Elevation Myocardial Infarction Treated With Primary Angioplasty Anin Myocardial Infarction Registry

Kruk¹,

Przyłuski²,

Kalińczuk³

et al. 2009

Circ J

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Background Hemoglobin (Hb) levels may interact with inflammatory activation, but it is unknown whether the interaction has any impact on clinical outcomes in acute coronary syndromes. The aim of this study was to assess the relationship between admission Hb levels, leukocytosis and clinical outcomes of ST-elevation myocardial infarction (STEMI) treated with primary angioplasty. Methods and ResultsThe study group comprised 1,904 (1,380 men) patients with STEMI treated with primary percutaneous coronary intervention, enrolled in a prospective registry. The primary endpoint of in-hospital death occurred in 90 (4.7%) patients. According to univariate analysis, extreme values of Hb (for 1 st and 5 th vs mid quintiles respectively: hazard ratio (HR) =7.1, P<0.001 and HR =3.2, P=0.024) and leukocytosis above median (HR =2.09, P=0.001) significantly correlated with in-hospital death. After dividing patients into high and low white blood cell (WBC) count groups, a U-shaped relationship of Hb levels and mortality was observed for patients with higher leukocytosis (1 st and 5 th vs mid quintiles respectively: HR =8.1, P=0.001 and HR =4.4, P=0.022), whereas in patients with lower WBC count higher mortality was related solely to the lowest Hb quintile (HR =6.9, P=0.010 vs mid quintile). Conclusion Higher mortality associated with higher Hb levels in STEMI patients treated with primary angioplasty is limited to patients with increased leukocytosis. (Circ J 2009; 73: 323 -329)

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“…In the mid-1970s, it was suggested that raised hemoglobin concentrations and hyperviscosity of the blood were risk factors for CHD (Dormandy et al, 1973;Dormandy, 1975;Abu-Zeid and Chapman, 1976). This effect has been confirmed for hematocrit in a meta-analysis of 16 population-based studies where the relative risk was 1.16 (95% confidence interval (CI) 1.05-1.29) for the comparison of the top versus the bottom third and 1.81 (95% CI 1.19-2.76) for three studies of subjects with pre-existing vascular disease (Danesh et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Interest started in the 1970s in relation to blood viscosity (Dormandy et al, 1973;Dormandy, 1975;Abu-Zeid and Chapman, 1976) as a risk factor for thrombosis. Factors associated with blood viscosity were hemoglobin, hematocrit and fibrinogen, all of which have been shown in separate studies to relate positively to increased CHD risk (Danesh et al, 1998(Danesh et al, , 2000Lowe et al, 2000;Woodward et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Effect on hematologic risk factors for coronary heart disease of a cholesterol reducing diet

et al. 2006

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Clinical, Haemodynamic, Rheological, and Biochemical Findings in 126 Patients with Intermittent Claudication

Cited by 250 publications

References 21 publications

Association of Hemoglobin Levels With Clinical Outcomes in Acute Coronary Syndromes

Association of Hemoglobin Levels With Clinical Outcomes in Acute Coronary Syndromes

Hemoglobin, Leukocytosis and Clinical Outcomes of ST-Elevation Myocardial Infarction Treated With Primary Angioplasty Anin Myocardial Infarction Registry

Effect on hematologic risk factors for coronary heart disease of a cholesterol reducing diet

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