Anemia in Acute Coronary Syndrome: An Overview

Abstract

AbstractAnemia is very common in patients with cardiovascular diseases. It has been shown that anemia is an independent risk factor for cardiovascular events in general population and in patients of heart failure and acute coronary syndrome (ACS). Various randomized trials have shown prevalence of anemia to be 10 to 43% in patients with ACS. The cardiac remodeling in ACS patients results in left ventricular dilation, which further increases myocardial wall stress. In the presence of anemia, this exacerbates ischemia and enhances myocardial necrosis and fibrosis and ultimately the prognosis. At present, modality of treatment of anemia in ACS patients is less established except blood transfusion. Anemia at admission may have both short- and long-term worse prognosis. Restrictive strategy of blood transfusion, as shown by REALITY trial, may have at least short-term beneficial effect. Due attention should also be given to hospital-acquired anemia (HAA) and anemia developing later, that is, after discharge from hospital. Intravenous iron therapy may be the future therapeutic option, as evidenced by its beneficial effect in treatment of heart failure with anemia.