Am J Blood Res 2011;1(2):160-166
Review Article
A review of anemia as a cardiovascular risk factor in patients with
myelodysplastic syndromes
Esther N Oliva, Carina Schey, Adam S Hutchings
Hematology Unit, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy; GMAS. Bld 3 Chiswick Park,
London, W4 5YA, United Kingdom; GMAS. Bld 3 Chiswick Park, London, W4 5YA, United Kingdom
Received August 3, 2011; accepted September 5, 2011; Epub September 10, 2011; published September 30, 2011
Abstract: Background: Anemia is an important cause of morbidity in MDS patients, principally through increased
cardiovascular disease. Transfusion status has been seen to be a significant prognostic factor for disease progression and
mortality, yet the relationship between anemia levels and cardiovascular disease is not well understood. Objective: This study
aimed to review the published literature on the effect of anemia on cardiovascular outcomes in patients with MDS. Methods: A
systematic literature review was undertaken to identify studies that investigated the relationship between anemia (as defined
by hemoglobin levels) and cardiovascular outcomes in patients with MDS (all subtypes). Results: Three studies were
identified that explicitly evaluated the relationship between anemia and cardiovascular outcomes in MDS, and another study
reported the relationship between hemoglobin levels and survival. The four studies consistently showed a strong relationship
between lower hemoglobin levels and worse cardiovascular outcomes, including cardiac remodeling, congestive heart
failure, coronary artery disease, myocardial infarction, arrhythmia, heart valve disease, and cardiovascular mortality. Anemia
was seen to be an independent predictor of cardiovascular disease outcomes in patients with MDS, beyond transfusion
status and IPSS. Conclusion: Based upon a relatively small body of evidence, there appears to be a strong and clinically
significant association between anemia and cardiovascular morbidity and mortality in MDS. While further research is needed,
clinicians should seek to actively manage hemoglobin levels in MDS patients before the point of transfusion dependency is
reached. (AJBR1108001).
Keywords: Myelodysplastic syndromes, MDS, anemia, cardiovascular disease, mortality, quality of life, hemoglobin,
transfusion
Full Text PDF
Address all correspondence to:
Dr. Ester N Oliva
Hematology Unit
Azienda Ospedaliera "Bianchi-Melacrino-Morelli"
Reggio Calabria, Italy.
E-mail: estheroliva@hotmail.com
Review Article
A review of anemia as a cardiovascular risk factor in patients with
myelodysplastic syndromes
Esther N Oliva, Carina Schey, Adam S Hutchings
Hematology Unit, Azienda Ospedaliera "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy; GMAS. Bld 3 Chiswick Park,
London, W4 5YA, United Kingdom; GMAS. Bld 3 Chiswick Park, London, W4 5YA, United Kingdom
Received August 3, 2011; accepted September 5, 2011; Epub September 10, 2011; published September 30, 2011
Abstract: Background: Anemia is an important cause of morbidity in MDS patients, principally through increased
cardiovascular disease. Transfusion status has been seen to be a significant prognostic factor for disease progression and
mortality, yet the relationship between anemia levels and cardiovascular disease is not well understood. Objective: This study
aimed to review the published literature on the effect of anemia on cardiovascular outcomes in patients with MDS. Methods: A
systematic literature review was undertaken to identify studies that investigated the relationship between anemia (as defined
by hemoglobin levels) and cardiovascular outcomes in patients with MDS (all subtypes). Results: Three studies were
identified that explicitly evaluated the relationship between anemia and cardiovascular outcomes in MDS, and another study
reported the relationship between hemoglobin levels and survival. The four studies consistently showed a strong relationship
between lower hemoglobin levels and worse cardiovascular outcomes, including cardiac remodeling, congestive heart
failure, coronary artery disease, myocardial infarction, arrhythmia, heart valve disease, and cardiovascular mortality. Anemia
was seen to be an independent predictor of cardiovascular disease outcomes in patients with MDS, beyond transfusion
status and IPSS. Conclusion: Based upon a relatively small body of evidence, there appears to be a strong and clinically
significant association between anemia and cardiovascular morbidity and mortality in MDS. While further research is needed,
clinicians should seek to actively manage hemoglobin levels in MDS patients before the point of transfusion dependency is
reached. (AJBR1108001).
Keywords: Myelodysplastic syndromes, MDS, anemia, cardiovascular disease, mortality, quality of life, hemoglobin,
transfusion
Full Text PDF
Address all correspondence to:
Dr. Ester N Oliva
Hematology Unit
Azienda Ospedaliera "Bianchi-Melacrino-Morelli"
Reggio Calabria, Italy.
E-mail: estheroliva@hotmail.com
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