冠心病合并消化道出血的输血策略研究进展
摘要
<正>目前,研究~([1-19])认为贫血是冠状动脉粥样硬化性心脏病(简称冠心病),尤其是急性冠状动脉综合征(ACS)患者不良预后的重要预测因素。无论贫血是由其他基础疾病引起或治疗过程诱发,也不论贫血发生的时间,均会对ACS的预后产生影响。贫血是冠心病尤其是ACS患者短期和长期死亡的独立危险因素。血红蛋白为机体组织提供足够的氧供,不同人群及不同病理生理情况下,机体贫血反应情况及其所带来的结果是不
引文
[1]Putot A,Zeller M,Perrin S,et al.Blood transfusion in elderly patients with acute myocardial infarction:data from the RICO survey[J].Am J Med,2018,131(4):422-429
[2]Brener S J,Mehran R,Dangas G D,et al.Relation of baseline hemoglobin levels and adverse events in patients with acute coronary syndromes(from the Acute Catheterization and Urgent Intervention Triage strategy and Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction Trials)[J].Am J Cardiol,2017,119(11):1710-1716.
[3]Voss W B,Lee M,Devlin G P,et al.Incidence and type of bleeding complications early and late after acute coronary syndrome admission in a New Zealand cohort(ANZACS-QI-7)[J].N Z Med J,2016,129(1437):27-38.
[4]He L,Zhang J,Zhang S.Risk factors of in-hospital mortality among patients with upper gastrointestinal bleeding and acute myocardial infarction[J].Saudi J Gastroenterol,2018,24(3):177-182.
[5]Stucchi M,Cantoni S,Piccinelli E,et al.Anemia and acute coronary syndrome:current perspectives[J].Vasc Health Risk Manag,2018,14:109-118.
[6]Kunadian V,Mehran R,Lincoff A M,et al.Effect of anemia on frequency of short-and long-term clinical events in acute coronary syndromes(from the acute catheterization and urgent intervention triage strategy trial)[J].Am J Cardiol,2014;114(12):1823-1829.
[7]Shiraishi J,Kohno Y,Nakamura T,et al.Prognostic impact of chronic kidney disease and anemia at admission on inhospital outcomes after primary percutaneous coronary intervention for acute myocardial infarction[J].Int Heart J,2014,55(4):301-306.
[8]Yazji K,Abdul F,Elangovan S,et al.Baseline anemia in patients undergoing percutaneous coronary intervention after an acute coronary syndrome-aparadox of high bleeding risk,high ischemic risk,and complex coronary disease[J].J Interv Cardiol.2017;30(5):491-499.
[9]Vora A N,Peterson E D,Mccoy L A,et al.The Impact of Bleeding Avoidance Strategies on Hospital-Level Variation in Bleeding Rates Following Percutaneous Coronary Intervention:Insights From the National Cardiovascular Data Registry CathPCIRegistry[J].Jacc Cardiovascular Interventions,2016,9(8):771-779.
[10]Bates E R.Bleeding avoidance strategies,performance measures,and the emperor's new clothes[J].JACC:Cardiovascular Interventions,2016,9(8):780-783.
[11]Brener S J,Kirtane A J,Rinaldi M J,et al.Prediction of ischemic and bleeding events using the dual antiplatelet therapy score in an unrestricted percutaneous coronary intervention population[J].Circ Cardiovasc Interv,2018,11(10):006853.
[12]Salisbury A C,Amin A P,Reid K J,et al.Hospital-acquired anemia and in-hospital mortality in patients with acute myocardial infarction[J].Am Heart J,2011,162(2):300-309.
[13]Moady G,Iakobishvili Z,Beigel R,et al.The predictive value of low admission hemoglobin over the GRACE score in patients with acute coronary syndrome[J].J Cardiol,2019,73(4):271-275.
[14]Vicente-Ibarra N,Marín F,Pernías-Escrig V,et al.Impact of anemia as risk factor for major bleeding and mortality in patients with acute coronary syndrome[J].European Journal of Internal Medicine,2019,61:48-53.
[15]Sanchis J,Soler M,Nú珘nez J,et al.Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome[J].Eur J Intern Med,2019,62:48-53.
[16]Ge Z,Baber U,Claessen B E,et al.The prevalence,predictors and outcomes of guideline-directed medical therapy in patients with acute myocardial infarction undergoing PCI,an analysis from the PROMETHEUS registry[J].Catheter Cardiovasc Interv,2019,93(3):112-119.
[17]Ntima G,Bepouka B,Tixier V,et al.Anemia in patients with acute coronary syndrome in the Vichy Hospital center[J].Ann Cardiol Angeiol(Paris),2018,67(5):321-326.
[18]Guedeney P,Sorrentino S,Claessen B,et al.The link between anemia and adverse outcomes in patients with acute coronary syndrome[J].Expert Rev Cardiovasc Ther,2019,17(3):151-159.
[19]Baber U,Mehran R,Giustino G,et al.Coronary thrombosis and major bleeding after PCI with drug-eluting stents[J].JAm Coll Cardiol,2016,67(19):2224-2234.
[20]González-González J A,Monreal-Robles R,García-Compean D,et al.Nonvariceal upper gastrointestinal bleeding in elderly people:Clinical outcomes and prognostic factors[J].JDig Dis,2017,18(4):212-221.
[21]Alli O,Smith C,Hoffman M,et al.Incidence,predictors,outcomes of gastrointestinal bleeding in patients on dual antiplatelet therapy with aspirin and clopidogrel[J].J Clin Gastroenterol.2011;45(5):410-414.
[22]Wan J D,Wang P J,Zhou P,et al.Predictors and management of antiplatelet-related bleeding complications for acute coronary syndrome in Chinese elderly patients[J].Cell Physiol Biochem,2018,50(3):1164-1177.
[23]Brinkert M,Southern D A,James M T,et al.Incidence and prognostic implications of late bleeding after myocardial infarction or unstable angina according to treatment strategy[J].Can J Cardiol,2017;33(8):998-1005.
[24]Eikelboom J W,Connolly S J,Bosch J,et al.Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease[J].N Engl J Med,2017;377(14):1319-1330
[25]García Rodríguez L A,Martín-Pérez M,Hennekens C H,et al.Bleeding risk with long-term low-dose aspirin:Asystematic review of observational studies[J].PLoS One,2016,11(8):e0160046.
[26]杭敏,张妍琦,张蕾,等.双抗血小板聚集药物所致急性非静脉曲张性上消化道出血的临床特点及相关因素分析[J].内科急危重症杂志,2018,24(2):119-121.
[27]Wimmer N J,Dufour A B,Cho K,et al.Long-term outcomes in patients with acute coronary syndromes related to prolonging dual antiplatelet therapy more than 12months after coronary stenting[J].Cathet Cardiovasc Intervent,2017,89(7):1176-1184.
[28]Li L,Geraghty O C,Mehta Z,et al.Age-specific risks,severity,time course,and outcome of bleeding on long-term antiplatelet treatment after vascular events:A populationbased cohort study[J].Lancet,2017,390(10093):490-499.
[29]Hoedemaker N P G,Damman P,Ottervanger J P,et al.Trends in cardiovascular and bleeding outcomes in acute coronary syndrome patients treated with or without protonpump inhibitors during the introduction of novel P2Y12inhibitors:A five-year experience from a single-centre observational registry[J].Eur Heart J Cardiovasc Pharmacother,2018Aug 2.Epub ahead of print
[30]Crooks C J,West J,Card T R.Comorbidities affect risk of nonvariceal upper gastrointestinal bleeding[J].Gastroenterology,2013,144(7):1384-1393.
[31]Wu C J,Lin H J,Weng S F,et al.Acute myocardial infarction risk in patients with coronary artery disease doubled after upper gastrointestinal tract bleeding:Anationwide nested case-control study[J].PLoS One,2015,10(11):e0142000.
[32]Abraham N S.New clinical paradigms for treating and preventing antiplatelet gastrointestinal bleeding[J].Curr Opin Gastroenteroly,2017,33(6):467-472.
[33]Ozawa T,Suda M,Ikegami R,et al.Dual antiplatelet therapy guided by CYP2C19polymorphisms after implantation of secondgeneration drug-eluting stents for management of acute coronary syndrome[J].Int Heart J,2018,59(1):21-26.
[34]Mamas MA,Kwok CS,Kontopantelis E,et al.Relationship Between Anemia and Mortality Outcomes in a National Acute Coronary Syndrome Cohort:Insights From the UKMyocardial Ischemia National Audit Project Registry[J].JAm Heart Assoc,2016,5(11):003348.
[35]Farhan S,Baber U,Mehran R.Anemia and Acute Coronary Syndrome:Time for Intervention Studies[J].J Am Heart Assoc,2016,5(11):004908.
[36]Sudarsky D,Sudarsky M,Matezky S,et al.Impact of early invasive approach on outcomes of patients with acute coronary syndrome and baseline anemia:analysis from the ACSISregistry[J].J Interven Cardiol,2015,28(4):315-325.
[37]Yaylak B,Altlntas B,zcan KS,et al.Relation of hemoglobin level to no-reflow in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention[J].Postepy Kardiol Interwencyjnej.2018;14(4):383-390.
[38]Colombo M G,Kirchberger I,Amann U,et al.Association between admission anemia and long-term mortality in patients with acute myocardial infarction:Results from the MONICA/KORA myocardial infarction registry[J].BMCCardiovasc Disord,2018,18(1):50.
[39]Wang N,Li T,Du Q.Risk factors of upper gastrointestinal hemorrhage with acute coronary syndrome:A nested casecontrol study[J].Am J Emerg Med,2019,37(4):615-619.
[40]Kuhn V,Diederich L,Keller TCS 4th,et al.Red Blood Cell Function and Dysfunction:Redox Regulation,Nitric Oxide Metabolism,Anemia.Antioxid Redox Signal[J].2017,26(13):718-742.
[41]Solomon A,Blum A,Peleg A,et al.Endothelial progenitor cells are suppressed in anemic patients with acute coronary syndrome[J].Am J Med,2012,125(6):604-611.
[42]Yin Z,Yu B,Liu W,et al.Blood transfusion and mortality in myocardial infarction:an updated meta-analysis[J].Oncotarget,2017,8(60):102254-102262.
[43]Odutayo A,Desborough M J,Trivella M,et al.Restrictive versus liberal blood transfusion for gastrointestinal bleeding:a systematic review and meta-analysis of randomised controlled trials[J].Lancet Gastroenterol Hepatol,2017,2(5):354-360.
[44]Langhi D M,Covas D T,Marques J F C,et al.Guidelines on transfusion of red blood cells:Prognosis of patients who decline blood transfusions[J].Hematol Transfus Cell Ther,2018,40(4):377-381
[45]Mazer C D,Whitlock R P,Fergusson D A,et al.Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery[J].N Engl J Med.2018,379(13):1224-1233.
[46]Parimi N,Fontaine MJ,Yang S,et al.Blood Transfusion Indicators Following Trauma in the Non-Massively Bleeding Patient[J].Ann Clin Lab Sci,2018,48(3):279-285.
[47]Bagwe S,Chung LK,Lagman C,et al.Blood transfusion indications in neurosurgical patients:A systematic review[J].Clin Neurol Neurosurg,2017,155:83-89.
[48]Carson J L,Guyatt G,Heddle N M,et al.Clinical practice guidelines from the AABB[J].JAMA,2016,316(19):2025-2035.
[49]Strate L L,Gralnek I M.ACG clinical guideline:management of patients with acute lower gastrointestinal bleeding[J].Am J Gastroenterol 2016,111(4):459-474.
[50]Mincu R I,Rassaf T,Totzeck M.Red blood cell transfusion in patients with ST-elevation myocardial infarction:A metaanalysis of more than 21,000patients[J].Neth Heart J,2018,26(9):454-460.
[51]Garfinkle M,Lawler P R,Filion K B,Eisenberg M J.Red blood cell transfusion and mortality among patients hospitalized for acute coronary syndromes:a systematic review[J].Int J Cardiol.2013;164(2):151-157.
[52]Docherty A B,O'Donnell R,Brunskill S,et al.Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting:systematic review and meta-analysis[J].BMJ,2016;352:i1351.
[53]Wang Y S,Shi X L,Wen M Q,et al.Restrictive versus liberal blood transfusion in patients with coronary artery disease:A meta-analysis[J].Current Medical Research and Opinion,2017,33(4):761-768.
[2]Brener S J,Mehran R,Dangas G D,et al.Relation of baseline hemoglobin levels and adverse events in patients with acute coronary syndromes(from the Acute Catheterization and Urgent Intervention Triage strategy and Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction Trials)[J].Am J Cardiol,2017,119(11):1710-1716.
[3]Voss W B,Lee M,Devlin G P,et al.Incidence and type of bleeding complications early and late after acute coronary syndrome admission in a New Zealand cohort(ANZACS-QI-7)[J].N Z Med J,2016,129(1437):27-38.
[4]He L,Zhang J,Zhang S.Risk factors of in-hospital mortality among patients with upper gastrointestinal bleeding and acute myocardial infarction[J].Saudi J Gastroenterol,2018,24(3):177-182.
[5]Stucchi M,Cantoni S,Piccinelli E,et al.Anemia and acute coronary syndrome:current perspectives[J].Vasc Health Risk Manag,2018,14:109-118.
[6]Kunadian V,Mehran R,Lincoff A M,et al.Effect of anemia on frequency of short-and long-term clinical events in acute coronary syndromes(from the acute catheterization and urgent intervention triage strategy trial)[J].Am J Cardiol,2014;114(12):1823-1829.
[7]Shiraishi J,Kohno Y,Nakamura T,et al.Prognostic impact of chronic kidney disease and anemia at admission on inhospital outcomes after primary percutaneous coronary intervention for acute myocardial infarction[J].Int Heart J,2014,55(4):301-306.
[8]Yazji K,Abdul F,Elangovan S,et al.Baseline anemia in patients undergoing percutaneous coronary intervention after an acute coronary syndrome-aparadox of high bleeding risk,high ischemic risk,and complex coronary disease[J].J Interv Cardiol.2017;30(5):491-499.
[9]Vora A N,Peterson E D,Mccoy L A,et al.The Impact of Bleeding Avoidance Strategies on Hospital-Level Variation in Bleeding Rates Following Percutaneous Coronary Intervention:Insights From the National Cardiovascular Data Registry CathPCIRegistry[J].Jacc Cardiovascular Interventions,2016,9(8):771-779.
[10]Bates E R.Bleeding avoidance strategies,performance measures,and the emperor's new clothes[J].JACC:Cardiovascular Interventions,2016,9(8):780-783.
[11]Brener S J,Kirtane A J,Rinaldi M J,et al.Prediction of ischemic and bleeding events using the dual antiplatelet therapy score in an unrestricted percutaneous coronary intervention population[J].Circ Cardiovasc Interv,2018,11(10):006853.
[12]Salisbury A C,Amin A P,Reid K J,et al.Hospital-acquired anemia and in-hospital mortality in patients with acute myocardial infarction[J].Am Heart J,2011,162(2):300-309.
[13]Moady G,Iakobishvili Z,Beigel R,et al.The predictive value of low admission hemoglobin over the GRACE score in patients with acute coronary syndrome[J].J Cardiol,2019,73(4):271-275.
[14]Vicente-Ibarra N,Marín F,Pernías-Escrig V,et al.Impact of anemia as risk factor for major bleeding and mortality in patients with acute coronary syndrome[J].European Journal of Internal Medicine,2019,61:48-53.
[15]Sanchis J,Soler M,Nú珘nez J,et al.Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome[J].Eur J Intern Med,2019,62:48-53.
[16]Ge Z,Baber U,Claessen B E,et al.The prevalence,predictors and outcomes of guideline-directed medical therapy in patients with acute myocardial infarction undergoing PCI,an analysis from the PROMETHEUS registry[J].Catheter Cardiovasc Interv,2019,93(3):112-119.
[17]Ntima G,Bepouka B,Tixier V,et al.Anemia in patients with acute coronary syndrome in the Vichy Hospital center[J].Ann Cardiol Angeiol(Paris),2018,67(5):321-326.
[18]Guedeney P,Sorrentino S,Claessen B,et al.The link between anemia and adverse outcomes in patients with acute coronary syndrome[J].Expert Rev Cardiovasc Ther,2019,17(3):151-159.
[19]Baber U,Mehran R,Giustino G,et al.Coronary thrombosis and major bleeding after PCI with drug-eluting stents[J].JAm Coll Cardiol,2016,67(19):2224-2234.
[20]González-González J A,Monreal-Robles R,García-Compean D,et al.Nonvariceal upper gastrointestinal bleeding in elderly people:Clinical outcomes and prognostic factors[J].JDig Dis,2017,18(4):212-221.
[21]Alli O,Smith C,Hoffman M,et al.Incidence,predictors,outcomes of gastrointestinal bleeding in patients on dual antiplatelet therapy with aspirin and clopidogrel[J].J Clin Gastroenterol.2011;45(5):410-414.
[22]Wan J D,Wang P J,Zhou P,et al.Predictors and management of antiplatelet-related bleeding complications for acute coronary syndrome in Chinese elderly patients[J].Cell Physiol Biochem,2018,50(3):1164-1177.
[23]Brinkert M,Southern D A,James M T,et al.Incidence and prognostic implications of late bleeding after myocardial infarction or unstable angina according to treatment strategy[J].Can J Cardiol,2017;33(8):998-1005.
[24]Eikelboom J W,Connolly S J,Bosch J,et al.Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease[J].N Engl J Med,2017;377(14):1319-1330
[25]García Rodríguez L A,Martín-Pérez M,Hennekens C H,et al.Bleeding risk with long-term low-dose aspirin:Asystematic review of observational studies[J].PLoS One,2016,11(8):e0160046.
[26]杭敏,张妍琦,张蕾,等.双抗血小板聚集药物所致急性非静脉曲张性上消化道出血的临床特点及相关因素分析[J].内科急危重症杂志,2018,24(2):119-121.
[27]Wimmer N J,Dufour A B,Cho K,et al.Long-term outcomes in patients with acute coronary syndromes related to prolonging dual antiplatelet therapy more than 12months after coronary stenting[J].Cathet Cardiovasc Intervent,2017,89(7):1176-1184.
[28]Li L,Geraghty O C,Mehta Z,et al.Age-specific risks,severity,time course,and outcome of bleeding on long-term antiplatelet treatment after vascular events:A populationbased cohort study[J].Lancet,2017,390(10093):490-499.
[29]Hoedemaker N P G,Damman P,Ottervanger J P,et al.Trends in cardiovascular and bleeding outcomes in acute coronary syndrome patients treated with or without protonpump inhibitors during the introduction of novel P2Y12inhibitors:A five-year experience from a single-centre observational registry[J].Eur Heart J Cardiovasc Pharmacother,2018Aug 2.Epub ahead of print
[30]Crooks C J,West J,Card T R.Comorbidities affect risk of nonvariceal upper gastrointestinal bleeding[J].Gastroenterology,2013,144(7):1384-1393.
[31]Wu C J,Lin H J,Weng S F,et al.Acute myocardial infarction risk in patients with coronary artery disease doubled after upper gastrointestinal tract bleeding:Anationwide nested case-control study[J].PLoS One,2015,10(11):e0142000.
[32]Abraham N S.New clinical paradigms for treating and preventing antiplatelet gastrointestinal bleeding[J].Curr Opin Gastroenteroly,2017,33(6):467-472.
[33]Ozawa T,Suda M,Ikegami R,et al.Dual antiplatelet therapy guided by CYP2C19polymorphisms after implantation of secondgeneration drug-eluting stents for management of acute coronary syndrome[J].Int Heart J,2018,59(1):21-26.
[34]Mamas MA,Kwok CS,Kontopantelis E,et al.Relationship Between Anemia and Mortality Outcomes in a National Acute Coronary Syndrome Cohort:Insights From the UKMyocardial Ischemia National Audit Project Registry[J].JAm Heart Assoc,2016,5(11):003348.
[35]Farhan S,Baber U,Mehran R.Anemia and Acute Coronary Syndrome:Time for Intervention Studies[J].J Am Heart Assoc,2016,5(11):004908.
[36]Sudarsky D,Sudarsky M,Matezky S,et al.Impact of early invasive approach on outcomes of patients with acute coronary syndrome and baseline anemia:analysis from the ACSISregistry[J].J Interven Cardiol,2015,28(4):315-325.
[37]Yaylak B,Altlntas B,zcan KS,et al.Relation of hemoglobin level to no-reflow in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention[J].Postepy Kardiol Interwencyjnej.2018;14(4):383-390.
[38]Colombo M G,Kirchberger I,Amann U,et al.Association between admission anemia and long-term mortality in patients with acute myocardial infarction:Results from the MONICA/KORA myocardial infarction registry[J].BMCCardiovasc Disord,2018,18(1):50.
[39]Wang N,Li T,Du Q.Risk factors of upper gastrointestinal hemorrhage with acute coronary syndrome:A nested casecontrol study[J].Am J Emerg Med,2019,37(4):615-619.
[40]Kuhn V,Diederich L,Keller TCS 4th,et al.Red Blood Cell Function and Dysfunction:Redox Regulation,Nitric Oxide Metabolism,Anemia.Antioxid Redox Signal[J].2017,26(13):718-742.
[41]Solomon A,Blum A,Peleg A,et al.Endothelial progenitor cells are suppressed in anemic patients with acute coronary syndrome[J].Am J Med,2012,125(6):604-611.
[42]Yin Z,Yu B,Liu W,et al.Blood transfusion and mortality in myocardial infarction:an updated meta-analysis[J].Oncotarget,2017,8(60):102254-102262.
[43]Odutayo A,Desborough M J,Trivella M,et al.Restrictive versus liberal blood transfusion for gastrointestinal bleeding:a systematic review and meta-analysis of randomised controlled trials[J].Lancet Gastroenterol Hepatol,2017,2(5):354-360.
[44]Langhi D M,Covas D T,Marques J F C,et al.Guidelines on transfusion of red blood cells:Prognosis of patients who decline blood transfusions[J].Hematol Transfus Cell Ther,2018,40(4):377-381
[45]Mazer C D,Whitlock R P,Fergusson D A,et al.Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery[J].N Engl J Med.2018,379(13):1224-1233.
[46]Parimi N,Fontaine MJ,Yang S,et al.Blood Transfusion Indicators Following Trauma in the Non-Massively Bleeding Patient[J].Ann Clin Lab Sci,2018,48(3):279-285.
[47]Bagwe S,Chung LK,Lagman C,et al.Blood transfusion indications in neurosurgical patients:A systematic review[J].Clin Neurol Neurosurg,2017,155:83-89.
[48]Carson J L,Guyatt G,Heddle N M,et al.Clinical practice guidelines from the AABB[J].JAMA,2016,316(19):2025-2035.
[49]Strate L L,Gralnek I M.ACG clinical guideline:management of patients with acute lower gastrointestinal bleeding[J].Am J Gastroenterol 2016,111(4):459-474.
[50]Mincu R I,Rassaf T,Totzeck M.Red blood cell transfusion in patients with ST-elevation myocardial infarction:A metaanalysis of more than 21,000patients[J].Neth Heart J,2018,26(9):454-460.
[51]Garfinkle M,Lawler P R,Filion K B,Eisenberg M J.Red blood cell transfusion and mortality among patients hospitalized for acute coronary syndromes:a systematic review[J].Int J Cardiol.2013;164(2):151-157.
[52]Docherty A B,O'Donnell R,Brunskill S,et al.Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting:systematic review and meta-analysis[J].BMJ,2016;352:i1351.
[53]Wang Y S,Shi X L,Wen M Q,et al.Restrictive versus liberal blood transfusion in patients with coronary artery disease:A meta-analysis[J].Current Medical Research and Opinion,2017,33(4):761-768.