Chronic anemia and non-ST elevation acute coronary syndrome - double jeopardy
Phillip Freeman1, James Berrill2, John Green3
1a Cardiff University School of Medicine, Wales Heart Research Institute, Institute of Molecular and Experimental Medicine, Heath Park , Cardiff , UK ;
Insights
This review addresses anemia in patients with non-ST-elevation acute coronary syndromes (NSTEACS). It provides strategies for managing gastrointestinal (GI) bleeding and anemia, improving patient outcomes.
Area of Science:
- Cardiology
- Gastroenterology
- Internal Medicine
Background:
- Anemia is common in patients with non-ST-elevation acute coronary syndromes (NSTEACS).
- Gastrointestinal (GI) bleeding is a significant cause of anemia in these patients.
- Misconceptions exist regarding the management of anemia and GI bleeding in NSTEACS patients.
Purpose of the Study:
- To outline management priorities from cardiology and gastroenterology viewpoints.
- To clarify misconceptions surrounding anemia and GI bleeding in NSTEACS.
- To propose evidence-based strategies for optimizing patient management.
Main Methods:
- Review of current evidence on anemia and GI bleeding in NSTEACS.
- Integration of cardiology and gastroenterology perspectives.
- Development of management strategies.
Main Results:
- Identification of GI etiology is crucial for adjusting investigations and treatments.
- Strategies aim to reduce bleeding complications and their impact.
- Focus on NSTEACS with chronic or sub-acute anemia, excluding acute GI bleeding.
Conclusions:
- Optimizing the management of anemia in NSTEACS patients is essential.
- Addressing potential GI causes of anemia improves patient care.
- Integrated GI and cardiovascular approaches reduce bleeding risks.
Abstract:
This review outlines the priorities from cardiology and gastroenterology perspectives, resolves some of the misconceptions, and uses the evidence available to suggest strategies for optimizing management of these patients. The dual presentation of acute active gastrointestinal (GI) blood loss together with an acute coronary syndrome (NSTEACS or STEMI) is outside the remit of this review but has been previously reviewed by our group. The review covers NSTEACS together with chronic or sub-acute anemia, anemia that cannot be accounted for by chronic kidney disease, heart failure, or inflammatory disorders. Identification of a potential GI etiology of anemia is important as it allows adjustment to both GI and CV investigations and treatments that can reduce the likelihood and impact of bleeding complications.
Related Concept Videos
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Acute Coronary Syndrome V: Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Angina II: Classification