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Medicina de Familia. SEMERGEN
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Inicio Medicina de Familia. SEMERGEN Dual antiplatelet therapy and an anemia subtype
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Vol. 44. Núm. 2.Marzo 2018
Páginas e77-e84Páginas 77-150
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Visitas
199
Vol. 44. Núm. 2.Marzo 2018
Páginas e77-e84Páginas 77-150
Letter to the Editor
DOI: 10.1016/j.semerg.2016.06.013
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Dual antiplatelet therapy and an anemia subtype
Doble antiagregación y subtipo de anemia
Visitas
199
L. Cerit
Department of Cardiology, Near East University Hospital, Nicosia, Cyprus
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To The Editor,
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I have read the article entitled “Dual antiplatelet therapy and hemoglobin level: An observational study” by Quinteiro-Alonso et al.1 with great interest, recently published in Semergen 2015 Sep 18. The investigators reported that Dual antiplatelet therapy is associated with a decrease in Hb. Anemia or worsening of previous anemia appeared in about half of the subjects.1

Anemia has been defined as an independent cardiovascular risk factor; its presence portends poor outcomes in patients with coronary artery disease. It is associated with higher rates of in-hospital mortality in patients with myocardial infarction2. Anemia was classified using mean corpuscular volume as microcytic, normocytic, or macrocytic. Blood loss could result in a normocytic anemia, reflecting acute loss of blood cells along with blood volume, or a microcytic anemia due to iron deficiency in patients with chronic blood loss. Shishehbor et al.3 reported that patients with macrocytic anemia have the highest mortality after PCI compare to normocytic, and micrcytic anemia. Macrocytosis is considered a structural and functional abnormality of the erythrocyte membrane. The spectrum of etiologies associated with macrocytosis accompanied by anemia includes malnutrition, such as vitamin B12 and folate deficiency, use of chemotherapeutic and anticonvulsant agents, alcoholism with chronic liver damage4. As well as, macrocytosis is an independent predictor of adverse outcomes after PCI regardless of the presence or absence of anemia.5

In this context, it might be beneficial to evaluate adverse outcomes depending on subtypes of anemia after DES implantation.

Conflict of interest

None.

References
[1]
M.P. Quinteiro-Alonso, M. González-Cao, C. Barreales-Cardín, G.J. Díaz-Grávalos
Dual antiplatelet therapy and haemoglobin level: an observational study
pii: S1138-3593(15)00250-6 [Epub ahead of print]
[2]
W.C. Wu, S.S. Rathore, Y. Wang, M.J. Radford, H.M. Krumholz
Blood transfusion in elderly patients with acute myocardial infarction
N Engl J Med, 345 (2001), pp. 1230-1236 http://dx.doi.org/10.1056/NEJMoa010615
[3]
M.H. Shishehbor, S.J. Filby, A.K. Chhatriwalla, R.D. Christofferson, A. Jain, S.R. Kapadia
Impact of drug-eluting versus bare-metal stents on mortality in patients with anemia
JACC Cardiovasc Interv, 2 (2009), pp. 329-336 http://dx.doi.org/10.1016/j.jcin.2008.11.014
[4]
F. Aslinia, J.J. Mazza, S.H. Yale
Megaloblastic anemia and other causes of macrocytosis
Clin Med Res, 4 (2006), pp. 236-241
[5]
M. Myojo, H. Iwata, T. Kohro, H. Sato, A. Kiyosue, J. Ando
Prognostic implication of macrocytosis on adverse outcomes after coronary intervention
Copyright © 2016. Sociedad Española de Médicos de Atención Primaria (SEMERGEN)
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