Anemia in Intensive Cardiac Care Unit patients – An underestimated problem

Uscinska, Ewa; Idźkowska, Ewelina; Sobkowicz, Bożena; Musiał, Włodzimierz J.; Tycińska, Agnieszka

doi:10.1016/j.advms.2015.06.002

Cited by 11 publications

(4 citation statements)

References 84 publications

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“…31 The impact of anaemia may be physiologically modulated by increased cardiac output, decreased peripheral vascular resistance, and decreased whole blood viscosity (to increase tissue perfusion), but it could be proarrhythmogenic or lead to a cardiac metabolic imbalance. 32 As observed in our results, there was a parallel correlation between increasing HTC levels and decreasing both mortality and MCE rates. Wu and colleagues 29 had also reported that the cardiac event rate increased monotonically for patients with progressively decreased HTC levels.…”

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confidence: 86%

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients

et al. 2017

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Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes. Material and Methods: This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression.Results: A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001). Discussion: A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients. Conclusion:Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.

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confidence: 86%

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients

et al. 2017

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“…Cardiac insufficiency is frequently accompanied by anemia, which might have a deleterious influence on treatment outcomes [ 78 ]. Heart failure anemia may be caused by inflammation, renal dysfunction, or iron shortage [ 79 ].…”

Section: Role Of Eryptosis In Diseasementioning

confidence: 99%

Molecular Mechanisms and Pathophysiological Significance of Eryptosis

Alghareeb

Alfhili

Fatima

2023

IJMS

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Despite lacking the central apoptotic machinery, senescent or damaged RBCs can undergo an unusual apoptosis-like cell death, termed eryptosis. This premature death can be caused by, or a symptom of, a wide range of diseases. However, various adverse conditions, xenobiotics, and endogenous mediators have also been recognized as triggers and inhibitors of eryptosis. Eukaryotic RBCs are unique among their cell membrane distribution of phospholipids. The change in the RBC membrane composition of the outer leaflet occurs in a variety of diseases, including sickle cell disease, renal diseases, leukemia, Parkinson’s disease, and diabetes. Eryptotic erythrocytes exhibit various morphological alterations such as shrinkage, swelling, and increased granulation. Biochemical changes include cytosolic Ca2+ increase, oxidative stress, stimulation of caspases, metabolic exhaustion, and ceramide accumulation. Eryptosis is an effective mechanism for the elimination of dysfunctional erythrocytes due to senescence, infection, or injury to prevent hemolysis. Nevertheless, excessive eryptosis is associated with multiple pathologies, most notably anemia, abnormal microcirculation, and prothrombotic risk; all of which contribute to the pathogenesis of several diseases. In this review, we provide an overview of the molecular mechanisms, physiological and pathophysiological relevance of eryptosis, as well as the potential role of natural and synthetic compounds in modulating RBC survival and death.

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“…Reduced ability to carry oxygen to an already under-perfused myocardium [9], impaired vascular healing [10], increased inflammatory influx [11], heightened risk of thrombosis [12], need for whole blood or packed cell transfusions [13], and differing medication profiles [14,15] can all contribute to adverse outcomes in ACS patients with anemia. Considering these mechanistic explanations, anemia can be expected to influence both shortterm and long-term outcomes after ACS [16][17][18]. In an elegant meta-analysis of 19 published studies covering data on 241,293 ACS patients, Liu et al [19] concluded that anemia is an independent predictor of adverse outcomes and should be used for risk-stratification in ACS patients.…”

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confidence: 99%

Incremental Prognostic Value of Anemia in Acute Coronary Syndrome from A Rural Hospital in India

Chiwhane

Burchundi

Manakshe

et al. 2020

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Background: Anemia is highly prevalent in low-and middle-income countries, where prevalence of acute coronary syndrome (ACS) is also rising. Evidence indicates that baseline anemia status can prognosticate ACS. However, the Global Registry of Acute Coronary Events (GRACE) score that is popularly used all over the world does not include information on anemia. Objectives: Our objective was to investigate if anemia at admission, along with the GRACE score, improves the prediction of adverse outcomes within 6 months in rural Indian patients of ACS. Methods: We enrolled 200 ACS patients at the Acharya Vinoba Bhave Rural Hospital-a rural, tertiary care hospital in central India. Patients were followed for 6 months for death and major adverse cardiac event (MACE). Improvement in the prediction of adverse events by including anemia in addition to the GRACE score was quantified using area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI) and the net reclassification index (NRI). Results: There were 31 deaths due to MACE and an additional 28 non-fatal MACE events during follow-up. Baseline hemoglobin was strongly and independently associated with both outcomes even after adjusting for a multivariable propensity score. For the outcome of death and death/MACE there was a moderate improvement in the AUC of 1% and 6%, respectively. However, for these outcomes the IDI for baseline hemoglobin was 6% (p = 0.03) and 12% (p << 0.0001), respectively, while the NRI was 0.50 (p = 0.01) and 0.78 (p << 0.0001), respectively. Conclusions: Inclusion of baseline anemia in addition to the GRACE score improves prognostication of ACS patients.

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Anemia in Intensive Cardiac Care Unit patients – An underestimated problem

Cited by 11 publications

References 84 publications

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients

Molecular Mechanisms and Pathophysiological Significance of Eryptosis

Incremental Prognostic Value of Anemia in Acute Coronary Syndrome from A Rural Hospital in India

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