Anaemia in heart failure patients, associated with angiotensin – Renin – aldosterone system altering medications

Jonaitienė, Neda; Ramantauskaitė, Grytė; Laukaitienė, Jolanta

doi:10.4103/heartviews.heartviews_211_20

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…The renin–angiotensin–aldosterone system (RAAS) principally impacts systemic fluid regulation: it is responsible for tubular sodium reabsorption and concomitant water retention; the action of angiotensin II on angiotensin receptor 1 (AT1) induces glomerulus hypoperfusion due to the vasoconstriction of the afferent and efferent arterioles: this reduces the filtration rate of the kidney and promotes systemic fluid accumulation [ 46 ]. Indeed, hypoperfusion of the kidney due to RAAS activation may lead to an increase in oxygen demand and thereby stimulate erythropoietin (EPO) production [ 47 ]. Therefore, medications for HF might promote anaemia occurrence in HF.…”

Section: Discussionmentioning

confidence: 99%

Anaemia and Congestion in Heart Failure: Correlations and Prognostic Role

Scicchitano¹,

Iacoviello

Massari³

et al. 2023

Biomedicines

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The aim of this study was to evaluate the relationship between anaemia and biomarkers of central/peripheral congestion in heart failure (HF) and the impact on mortality. We retrospectively evaluated 434 acute/chronic HF (AHF/CHF) patients. Anaemia was defined as haemoglobin levels <12 g/dL (women) or <13 g/dL (men). The brain natriuretic peptide (BNP) and hydration index (HI) were measured. The endpoint of the study was all-cause mortality. Anaemia occurred in 59% of patients with AHF and in 35% with CHF (p < 0.001) and showed a significant correlation with the NYHA functional class and renal function. BNP and HI were significantly higher in patients with anaemia than in those without anaemia. Independent predictors of anaemia included BNP, estimated creatinine clearance (eCrCL), and HI. The all-cause mortality rate was 21%, which was significantly higher in patients with anaemia than in those without anaemia (30% vs. 14%, p < 0.001; hazard ratio: 2.6). At multivariate Cox regression analysis, BNP, eCrCL, and HI were independent predictors for mortality (Hazard ratios: 1.0002, 0.97, and 1.05, respectively), while anaemia was not. Anaemia correlates with HF status, functional class, renal function, BNP, and HI. Anaemia was not an independent predictor for mortality, acting as a disease severity marker in congestive patients rather than as a predictor of death.

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Section: Discussionmentioning

confidence: 99%

Anaemia and Congestion in Heart Failure: Correlations and Prognostic Role

Scicchitano¹,

Iacoviello

Massari³

et al. 2023

Biomedicines

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“…In the aging population there is a growing prevalence of chronic heart failure (HF). HF is accompanied by systemic and functional iron deficiency [52]. The underlying causes of iron deficiency in HF include reduced protein uptake, fluid overload, antiplatelet drug use, increased hepcidin levels and intestinal wall oedema [53,54].…”

Section: Iron In Heart Metabolismmentioning

confidence: 99%

Can Iron Play a Crucial Role in Maintaining Cardiovascular Health in the 21st Century?

Szklarz

Gontarz-Nowak

Matuszewski

et al. 2022

IJERPH

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In the 21st century the heart is facing more and more challenges so it should be brave and iron to meet these challenges. We are living in the era of the COVID-19 pandemic, population aging, prevalent obesity, diabetes and autoimmune diseases, environmental pollution, mass migrations and new potential pandemic threats. In our article we showed sophisticated and complex regulations of iron metabolism. We discussed the impact of iron metabolism on heart diseases, treatment of heart failure, diabetes and obesity. We faced the problems of constant stress, climate change, environmental pollution, migrations and epidemics and showed that iron is really essential for heart metabolism in the 21st century.

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“…Por otro lado, se ha observado que la deficiencia de ácido fólico o vitamina B12 no contribuye de forma importante en la anemia de la insuficiencia cardiaca (16) . Igualmente, se ha propuesto el papel de la angiotensina II en la producción de hematíes, ya sea por la estimulación de la producción de eritropoyetina o por efectos directos en la eritropoyesis en la medula ósea, aunque aún no hay consenso sobre ello (17) . La coexistencia de insuficiencia cardiaca y enfermedad renal crónica aumenta el riesgo de anemia; se ha observado que las caídas de los niveles de hemoglobina son similares a la caída de la tasa de filtración glomerular (18) .…”

Section: Introductionunclassified

Riesgo de muerte por insuficiencia cardiaca congestiva en pacientes anémicos de la población peruana

Guevara Tirado

2023

Horizmed

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Objetivo: Determinar el riesgo de muerte por insuficiencia cardiaca congestiva subyacente en pacientes anémicos de la población peruana. Materiales y métodos: Estudio observacional, descriptivo, de casos y controles y retrospectivo basado en datos del Sistema Informático Nacional de Defunciones (Sinadef) del Ministerio de Salud (Minsa) peruano entre enero de 2021 y agosto de 2022. El muestreo fue no probabilístico, intencional por conveniencia según los criterios de inclusión y exclusión. Se incluyó a todos los pacientes con y sin anemia que fallecieron por insuficiencia cardiaca congestiva u otras comorbilidades, que sumaron un total de 35 724 personas. Las variables fueron anemia, definida como un trastorno del tamaño o número de hematíes, de la hemoglobina, así como de la absorción y disponibilidad del hierro, e insuficiencia cardiaca congestiva, definida como la incapacidad del miocardio para bombear sangre de forma competente. Se realizó la prueba de chi al cuadrado y de los coeficientes Phi y V de Cramer para determinar la existencia y grado de asociación de las variables y la razón de probabilidades para la estimación del riesgo. Se consideró un valor de p significativo menor del 0,05, con un intervalo de confianza al 95 %. Resultados: La anemia estuvo moderadamente asociada a la insuficiencia cardiaca congestiva: fallecieron 62,80 % de personas con anemia. Las variables están estadísticamente relacionadas y, según los coeficientes Phi y V de Cramer, se trata de una relación moderada. Se halló que los anémicos tuvieron 11,14 veces mayor riesgo de morir por insuficiencia cardiaca congestiva que las personas con otras comorbilidades. Conclusiones: La anemia se asocia a un alto riesgo de muerte por insuficiencia cardiaca subyacente en la población peruana. Es necesario el seguimiento de los niveles de hierro, hemoglobina y hematíes en pacientes con insuficiencia cardiaca, así como tratar las causas de estas deficiencias, con el objetivo de reducir la morbimortalidad en este grupo de pacientes.

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Anaemia in heart failure patients, associated with angiotensin – Renin – aldosterone system altering medications

Cited by 3 publications

References 28 publications

Anaemia and Congestion in Heart Failure: Correlations and Prognostic Role

Anaemia and Congestion in Heart Failure: Correlations and Prognostic Role

Can Iron Play a Crucial Role in Maintaining Cardiovascular Health in the 21st Century?

Riesgo de muerte por insuficiencia cardiaca congestiva en pacientes anémicos de la población peruana

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