Guedeney Paul, Sorrentino Sabato, Claessen Bimmer, Mehran Roxana
a The Zena and Michael A. Weiner Cardiovascular Institute , The Icahn School of Medicine at Mount Sinai , New York , USA.
b Institut de Cardiologie , Sorbonne Université, ACTION Study group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP) , Paris , France.
Expert Rev Cardiovasc Ther. 2019 Mar;17(3):151-159. doi: 10.1080/14779072.2019.1575729. Epub 2019 Feb 19.
Anemia is one of the most frequent comorbidities in acute coronary syndrome (ACS) patients and is associated with a significant impact on clinical outcomes. This review summarizes the knowledge and updated management of anemia in the setting of ACS. Areas covered: We provide a review on the prevalence, pathophysiology, prognosis, impact, and updated management of anemia. Expert opinion: Patients with anemia represent a therapeutic challenge in the setting of acute coronary syndrome and require specific acute and chronic management. Despite the high prevalence of anemia and the large amount of data confirming its strong impact on short- and long-term outcomes, a commonly used and accurate definition in the context of patients undergoing percutaneous coronary intervention and stent implantation for ACS is still lacking. Furthermore, therapeutic options to address anemia remain limited. The combined use of risk scores to identify high-risk characteristics for adverse bleeding or thrombotic events may guide individualized treatment of anemic patients, for example, by selecting an antiplatelet regimen aimed at minimizing bleeding or thrombotic risk. The optimal strategy for blood transfusion is currently being evaluated by an ongoing randomized trial.
贫血是急性冠状动脉综合征（ACS）患者中最常见的合并症之一，并且对临床结局有重大影响。本综述总结了ACS背景下贫血的相关知识及最新管理方法。涵盖领域：我们对贫血的患病率、病理生理学、预后、影响及最新管理方法进行了综述。专家观点：贫血患者在急性冠状动脉综合征背景下是一个治疗挑战，需要特定的急性和慢性管理。尽管贫血患病率很高，且大量数据证实其对短期和长期结局有强烈影响，但在接受经皮冠状动脉介入治疗和支架植入术的ACS患者中，仍缺乏常用且准确的定义。此外，治疗贫血的选择仍然有限。联合使用风险评分来识别出血或血栓形成不良事件的高危特征，可能会指导贫血患者的个体化治疗，例如，通过选择旨在将出血或血栓形成风险降至最低的抗血小板治疗方案。目前正在进行的一项随机试验正在评估输血的最佳策略。
