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Anemia of Chronic Disease in Patients With Cardiovascular Disease

Authors :
Tanja B. Grammer
Günter Weiss
Marcus E. Kleber
Lukas Lanser
Katharina Kurz
Hubert Scharnagl
Winfried März
Dietmar Fuchs
Source :
Frontiers in Cardiovascular Medicine, Frontiers in Cardiovascular Medicine, Vol 8 (2021)
Publication Year :
2021

Abstract

Objective:Anemia is often found in patients with coronary artery disease (CAD) or acute coronary syndrome (ACS) and related to disease severity. Our study investigated the relationship between anemia, iron homeostasis and inflammation in CAD and examined their influence on the outcome of patients.Patients and Methods:Markers of immune activation (neopterin, interleukin [IL]-12, IL-6, high sensitive C-reactive protein (hsCRP), fibrinogen, serum amyloid A [SAA]) and iron metabolism (ferritin, transferrin saturation, hemoglobin) were determined in 2,082 patients (68.7 % men, median age 63 years) from the Ludwigshafen Risk and cardiovascular Health (LURIC) cohort. Patients were followed-up for a median of 9.81 years.Results:960 patients (46.1 %) presented with chronic CAD, 645 patients (31.0 %) had an ACS, and 477 patients (22.9 %) presented with no CAD in coronary angiography (CAG). Anemia (n= 357, 17.1 %) was associated with disease severity (reflected by more progressed stenosis in CAG, CCS, and NYHA classes, and a lower LV-EF), a higher cardio-cerebrovascular event rate and higher levels of inflammatory markers. Interestingly, anemia was only predictive for an adverse outcome in patients with elevated inflammatory markers. Accordingly, anemia of chronic disease (ACD) was associated with a higher cardio-cerebrovascular event-rate in the subsequent 2 years as compared to patients with other types of anemia or without anemia (14.3 vs. 6.1 vs. 4.0%,p< 0.001).Conclusions:This study confirms that anemia and immune activation are strongly related to cardiovascular disease progression and an adverse outcome. Our data suggest that the association of anemia with disease severity and outcome might mainly be due to underlying inflammation.

Details

ISSN :
2297055X
Volume :
8
Database :
OpenAIRE
Journal :
Frontiers in cardiovascular medicine
Accession number :
edsair.doi.dedup.....2e0e0545665b4d775fe205f14306adc3