Anemia in ST-Elevation Myocardial Infarction Patients with Markers of Inadequate Bone Marrow Response.
Isr Med Assoc J
; 17(8): 500-4, 2015 Aug.
Article
in En
| MEDLINE
| ID: mdl-26394493
ABSTRACT
BACKGROUND:
Anemia confers an adverse prognosis in patients with ST-elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including inflammation, blood loss, and the presence of comorbidities such as renal failure.OBJECTIVES:
To evaluate the adequacy of bone marrow response as potentially reflected by elevation in blood and reticulocyte counts.METHODS:
Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours of symptom onset and who presented to our catheterization laboratory during a 36 month period were included in the study. The cohort was divided into quartiles according to hemoglobin concentration, and differences in clinical and laboratory characteristics between the groups were evaluated.RESULTS:
A total of 258 men with STEMI were recruited, 22% of whom suffered from anemia according to the World Health Organization classification (hemoglobin < 13 g/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell and platelet counts (9.6 ± 2.9 vs. 12.6 ± 3.6 x 103/µl, P < 0.001) and (231 ± 79 vs. 263 ± 8 x 103/µl, P < 0.01), respectively, despite higher inflammatory biomarkers (C-reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients, with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P = 0.292).CONCLUSIONS:
Anemic men with STEMI have relatively lower leukocyte and platelet counts as well as a reduced reticulocyte count despite higher inflammatory biomarkers. These findings might suggest inadequate bone marrow response.
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Database:
MEDLINE
Main subject:
Reticulocytes
/
Bone Marrow
/
Inflammation
/
Anemia
/
Leukocytes
/
Myocardial Infarction
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2015
Type:
Article