[The ability to pharmacological control of anemia and thrombocytopenia in patients with acute coronary syndromes].

Recently, attention has been paid to anemia (decreased number of red blood cells in peripheral blood and less than the normal quantity of hemoglobin) apart from the traditional methods used in determining prognosis in patients with acute cardiac syndrome (ACS). Thrombocytopenia and increased mean platelet volume (MPV) are listed among other--yet simple--laboratory blood tests which have prognostic significance in patients with ACS. In ACS patients it is necessary to distinguish between anemia which is established on admission to hospital (chronic anemia) and that acquired in the hospital (HAA). Anemia diagnosed on admission is an independent predictor of in-hospital mortality, short term and long term. In tum, hospital-acquired anemia is associated with the increase of in-hospital mortality, which further increases with greater decrease in Hb concentration. The prognostic value of Hb concentration was evaluated among others in patients with myocardial infarction. There was no beneficial effect of erythropoietin in patients with STEMI undergoing PCI, on the contrary, the increase of the adverse cardiovascular events and the risk of thromboembolic events was observed in selected groups of patients. The need of the administration of iron preparations is indicated in the case of anemia associated with iron deficiency or due to major bleeding. It was found that in patients with ACS even mild thrombocytopenia increases the risk of bleeding complications and in-hospital mortality, the risk of reinfarction, cardiogenic shock and stroke. Worse prognosis in patients with ACS is also associated with a decreased platelet count on admission to hospital and with increased mean platelet volume. In patients with ACS, we deal with heparin-induced thrombocytopenia or thrombocytopenia caused by the use of antiplatelet agents. The treatment of these causes of thrombocytopenia is an important issue. Increased platelet reactivity is observed in patients with increased MPV. This results in the development of restenosis, worse blood flow after PCI, in the increase in mortality and a higher incidence of the phenomenon of "no-reflow". The use of abciximab in STEMI and NSTEMI was associated with a decrease in MPV. Statins also caused a significant decrease in MPV.