Padda Jaskamal, Khalid Khizer, Hitawala Gazala, Batra Nitya, Pokhriyal Sindhu, Mohan Ayushi, Cooper Ayden Charlene, Jean-Charles Gutteridge
Internal Medicine, JC Medical Center, Orlando, USA.
Internal Medicine, Avalon University School of Medicine, Willemstad, CUW.
Cureus. 2021 Aug 11;13(8):e17096. doi: 10.7759/cureus.17096. eCollection 2021 Aug.
Various studies have established the prognosis of anemia in myocardial infarction (MI). Both chronic and acute anemia lead to poor outcomes in MI. Regardless, the association of anemia with MI and its management varies. In this study, the literature was analyzed to determine the association between acute anemia and MI based on the pathophysiology, outcomes, and management options. Acute anemia results in decreased blood supply and sudden hypoxia to the heart. Additionally, it exacerbates the preexisting compromised coronary blood supply in patients with MI. Thus, there is a disproportionate oxygen supply and demand ratio to the heart. It was found that anemia increases all-cause mortality in acute MI. However, it is unclear whether anemia is the direct contributor to mortality in these patients. For the management of MI, percutaneous coronary intervention (PCI) is commonly used. Increased incidence of hospital-acquired anemia (HAA) is reported in patients after PCI. However, the cause of HAA in these patients is not well established. Antiplatelet therapy in these patients is also considered to be the culprit for HAA. Nonetheless, no clear evidence is available. There is no consensus or criteria for the treatment of acute anemia in MI patients. Researchers have explored management options such as blood transfusion, erythropoietin-stimulating agent, and iron therapy. Further studies are warranted for a better understanding and management of MI in patients with anemia and vice versa.
多项研究已明确心肌梗死（MI）患者贫血的预后情况。慢性贫血和急性贫血均会导致心肌梗死患者预后不良。尽管如此，贫血与心肌梗死的关联及其管理方式各不相同。在本研究中，对文献进行了分析，以根据病理生理学、预后及管理方案来确定急性贫血与心肌梗死之间的关联。急性贫血会导致心脏供血减少和突然缺氧。此外，它会使心肌梗死患者原本就已受损的冠状动脉供血情况恶化。因此，心脏的氧供需比例失调。研究发现，贫血会增加急性心肌梗死患者的全因死亡率。然而，尚不清楚贫血是否是这些患者死亡的直接原因。对于心肌梗死的治疗，经皮冠状动脉介入治疗（PCI）是常用方法。据报道，接受PCI治疗的患者医院获得性贫血（HAA）的发生率有所增加。然而，这些患者发生HAA的原因尚未明确。这些患者的抗血小板治疗也被认为是导致HAA的原因。尽管如此，尚无明确证据。对于心肌梗死患者急性贫血的治疗，目前尚无共识或标准。研究人员已探索了输血、促红细胞生成素刺激剂和铁剂治疗等管理方案。有必要进行进一步研究，以更好地了解和管理贫血患者的心肌梗死情况，反之亦然。
