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Anemia in octogenarians with non-ST elevation acute coronary syndrome: Aging or disease?

2014; Elsevier BV; Volume: 176; Issue: 3 Linguagem: Inglês

10.1016/j.ijcard.2014.07.283

1874-1754

Nuccia Morici, Silvia Cantoni, Roberto Antonicelli, Ernesto Murena, Claudio Cavallini, Anna Sonia Petronio, Anna Toso, Francesco Bonechi, Stefano De Servi, Stefano Savonitto,

Hemoglobinopathies and Related Disorders

Several age-related changes have been associated with lower hemoglobin (Hb) values, not necessarily resulting in overt anemia, in the elderly population: muscle loss (sarcopenia) with subsequent decreased peripheral oxygen consumption, renal dysfunction with impaired erythropoietin production, stem cell function decline, decreased erythropoietin response to hypoxia of erythroid progenitors, and deranged inflammatory response [ 1 Lipschitz D.A. Mitchell C.O. Thompson C. The anemia of senescence. Am J Hematol. 1981; 11: 47-54 Crossref PubMed Scopus (106) Google Scholar , 2 Marley S.B1. Lewis J.L. Davidson R.J. et al. Evidence for a continuous decline in haemopoietic cell function from birth: application to evaluating bone marrow failure in children. Br J Haematol. 1999; 106: 162-166 Crossref PubMed Scopus (91) Google Scholar ]. Studies, performed in community-dwelling older adults, have clearly shown that when present, anemia is an independent predictor of outcome per se even in octogenarians [ [3] Izaks G.J1. Westendorp R.G. Knook D.L. The definition of anemia in older persons. JAMA. 1999; 281: 1714-1717 Crossref PubMed Scopus (394) Google Scholar ] and anemia of elderly patients is often considered a marker of frailty or of an underlying systemic disorder. Anemia is more frequent in the case of concomitant cardiovascular disease [ [4] Lawler P. Filion K. Dourian T. et al. Anemia and mortality in acute coronary syndromes: a systematic review and meta-analysis. Am Heart J. 2013; 165 (e5): 143-153 Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar ], often associated with the so called anemia of chronic disorders, and has been found in up to 43% of elderly patients admitted for acute heart disease [ [5] Joosten E. Pelemans W. Hiele M. et al. Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology. 1992; 38: 111-117 Crossref PubMed Scopus (201) Google Scholar ]. Weather anemia is somehow physiologically related to aging or should be viewed as a marker of underlying disease is still uncertain. This issue may have relevant clinical consequences especially as far as appropriateness of anemia correction in different settings is concerned.