Proinflammatory, immunomodulating, and prothrombotic properties of anemia and red blood cell transfusions

Twomley, Katie M.; Rao, Sunil V.; Becker, Richard C.

doi:10.1007/s11239-006-5206-4

Cited by 79 publications

(58 citation statements)

References 54 publications

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“…39,40 In addition, because transfused red blood cells s are deficient in nitric oxide (NO) and release excessive amounts of ADP, they increase platelet activation. 41 Yatskar et al 33 noted that in patients undergoing PCI, access site hematoma resulting in blood transfusion was independently associated with in-hospital mortality (OR, 3.59; 95% CI, 1.66-7.77) and 1-year death (hazard ratio, 1.65; 95% CI, 1.01-2.70; P=0.048). Similar findings were observed in the Mortality benefit Of Reduced Transfusion after PCI via the Arm or Leg (M.O.R.T.A.L) study, which compared transfusion rates and mortality in patients undergoing TRI versus TFI.…”

Section: Is a Decrease In Bleeding Or Blood Transfusion More Important?mentioning

confidence: 99%

Mechanisms by Which Transradial Approach May Reduce Mortality in ST-Segment–Elevation Myocardial Infarction

Huff

Kapadia

Rao

2014

Circ: Cardiovascular Interventions

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Section: Is a Decrease In Bleeding Or Blood Transfusion More Important?mentioning

confidence: 99%

Mechanisms by Which Transradial Approach May Reduce Mortality in ST-Segment–Elevation Myocardial Infarction

Huff

Kapadia

Rao

2014

Circ: Cardiovascular Interventions

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“…Patients with and without bleeding events had similar rates of in-hospital coronary revascularization with either PCI or CABG (67.8% versus 71.4%; Pϭ0. 19). …”

Section: Baseline Characteristicsmentioning

confidence: 99%

Antiplatelet Therapy Use After Discharge Among Acute Myocardial Infarction Patients With In-Hospital Bleeding

et al. 2008

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Background-Bleeding among patients with acute myocardial infarction (AMI) is associated with worse long-term outcomes. Although the mechanism underlying this association is unclear, a potential explanation is that withholding antiplatelet therapies long beyond resolution of the bleeding event may contribute to recurrent events. Methods and Results-We examined medication use at discharge, 1, 6, and 12 months after AMI among 2498 patients in the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) registry. Bleeding was defined as non-coronary artery bypass graft-related Thrombolysis of Myocardial Infarction major/minor bleeding or transfusion among patients with baseline hematocrit Ն28%. Logistic regression was used to evaluate the association between bleeding during the index AMI hospitalization and medication use. In-hospital bleeding occurred in 301 patients (12%) with AMI. Patients with in-hospital bleeding were less likely to be discharged on aspirin or thienopyridine (adjusted odds ratioϭ0.45; 95% CI, 0.31 to 0.64; and odds ratioϭ0.62; 95% CI, 0.42 to 0.91, respectively). At 1 month after discharge, although patients with in-hospital bleeding remained significantly less likely to receive aspirin (odds ratioϭ0.68; 95% CI, 0.50 to 0.92), use of thienopyridines in the 2 groups started to become similar. By 1 year, antiplatelet therapy use was similar among patients with and without bleeding. Postdischarge cardiology follow-up was associated with greater antiplatelet therapy use than either primary care or no clinical follow-up. Conclusions-Patients whose index AMI is complicated by bleeding are less likely to be treated with antiplatelet therapies during the first 6 months after discharge. Early reassessment of antiplatelet eligibility may represent an opportunity to reduce the long-term risk of adverse outcomes associated with bleeding. (Circulation. 2008;118:2139-2145.)

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“…Following PCI treatment, various complications may affect the patients' prognosis, particularly bleeding, which may reduce the patients' heart function and lead to MACE. The reason for this can be summarized by the following four points: i) Massive hemorrhage reduces the intravascular volume and increases the heart rate, resulting in an increase of myocardial oxygen consumption and a decrease in myocardial perfusion; ii) in order to treat a massive hemorrhage anticoagulation, antiplatelet and antithrombotic therapy is terminated, which increases the risk of myocardial ischemia and stent thrombosis; and iii) blood transfusion therapy may trigger the release of inflammatory mediators which, in turn, may increase the onset of stent thrombosis (21).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of various continued antiplatelet therapies in patients who were administered DAPT following the implantation of drug-eluting stents and developed gastrointestinal hemorrhage

Guo

Wei

2016

Experimental and Therapeutic Medicine

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Abstract. Although an increasing number of patients accept dual antiplatelet therapy (DAPT) following implantation of drug-eluting stents (DES) for coronary heart disease (CHD), the proportion of patients with DAPT who subsequently develop gastrointestinal hemorrhage continues to increase. To ensure the clinical outcomes from DES, it is important to formulate a novel continued antiplatelet therapy for patients who were administered DAPT and subsequently develop gastrointestinal hemorrhage following DES implantation. The present study aimed to evaluate the effects of continued aspirin, clopidogrel or DAPT use on the incidence of clinical adverse events and gastrointestinal rebleeding in patients who received DAPT and subsequently developed gastrointestinal hemorrhage following implantation of DES for CHD. Between 2004 and 2010, 108 consecutive patients receiving DAPT developed gastrointestinal hemorrhage following DES implantation for CHD at Liuzhou General Hospital (Liuzhou, Guangxi). These patients were divided into three groups according to the novel antiplatelet therapy. The occurrence of major adverse cardiac events (MACE), including cardiac death, non-fatal myocardial infarction, heart failure or target vessel revascularization, net adverse clinical events (NACE), including major bleeding, stroke or MACE, and gastrointestinal rebleeding during clinical follow-up following the initial procedure were compared among these three groups. The results of this analysis demonstrated that the occurrence rate of MACE, NECE and gastrointestinal rebleeding was not significantly different among these groups (P>0.05). Furthermore, survival analysis was performed and although the survival curves of MACE and NECE were not significantly different among these groups, gastrointestinal rebleeding was demonstrated to be significantly different among the three groups (P<0.05), and continued aspirin or clopidogrel use was superior to continued DAPT. In conclusion, the results of the present study indicated that there were no significant differences in the clinical effectiveness and safety of continuing antiplatelet monotherapy or DAPT in patients who are administered DAPT and experience gastrointestinal hemorrhage following DES implantation. As for the prevention of recurrent bleeding, antiplatelet monotherapy was demonstrated to be superior to DAPT. Moreover, the treatment of patients who are administered DAPT and experience gastrointestinal hemorrhage following DES implantation must involve an evaluation of the risk of complications, including stent thrombosis, continuous bleeding and recurrent hemorrhage.

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Proinflammatory, immunomodulating, and prothrombotic properties of anemia and red blood cell transfusions

Cited by 79 publications

References 54 publications

Mechanisms by Which Transradial Approach May Reduce Mortality in ST-Segment–Elevation Myocardial Infarction

Mechanisms by Which Transradial Approach May Reduce Mortality in ST-Segment–Elevation Myocardial Infarction

Antiplatelet Therapy Use After Discharge Among Acute Myocardial Infarction Patients With In-Hospital Bleeding

Clinical outcomes of various continued antiplatelet therapies in patients who were administered DAPT following the implantation of drug-eluting stents and developed gastrointestinal hemorrhage

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