Document Detail


Treatment of anemia in patients with heart disease: a clinical practice guideline from the American College of Physicians.
MedLine Citation:
PMID:  24297193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
DESCRIPTION: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the treatment of anemia and iron deficiency in adult patients with heart disease.
METHODS: This guideline is based on published literature in the English language on anemia and iron deficiency from 1947 to July 2012 that was identified using MEDLINE and the Cochrane Library. Literature was reassessed in April 2013, and additional studies were included. Outcomes evaluated for this guideline included mortality; hospitalization; exercise tolerance; quality of life; and cardiovascular events (defined as myocardial infarction, congestive heart failure exacerbation, arrhythmia, or cardiac death) and harms, including hypertension, venous thromboembolic events, and ischemic cerebrovascular events. The target audience for this guideline includes all clinicians, and the target patient population is anemic or iron-deficient adult patients with heart disease. This guideline grades the evidence and recommendations using the ACP's clinical practice guidelines grading system.
RECOMMENDATION 1: ACP recommends using a restrictive red blood cell transfusion strategy (trigger hemoglobin threshold of 7 to 8 g/dL compared with higher hemoglobin levels) in hospitalized patients with coronary heart disease. (Grade: weak recommendation; low-quality evidence) RECOMMENDATION 2: ACP recommends against the use of erythropoiesis-stimulating agents in patients with mild to moderate anemia and congestive heart failure or coronary heart disease. (Grade: strong recommendation; moderate-quality evidence).
Authors:
Amir Qaseem; Linda L Humphrey; Nick Fitterman; Melissa Starkey; Paul Shekelle;
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Publication Detail:
Type:  Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of internal medicine     Volume:  159     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-03     Completed Date:  2014-01-23     Revised Date:  2014-03-11    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  770-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia, Iron-Deficiency / complications*,  therapy*
Cause of Death
Coronary Disease / complications*,  mortality
Erythrocyte Transfusion / adverse effects
Exercise Tolerance
Heart Failure / complications*,  mortality
Hematinics / adverse effects,  therapeutic use
Humans
Injections, Intravenous
Iron / adverse effects,  therapeutic use
Quality of Life
Chemical
Reg. No./Substance:
0/Hematinics; E1UOL152H7/Iron
Comments/Corrections
Erratum In:
Ann Intern Med. 2014 Jan 21;160(2):144
Summary for patients in:
Ann Intern Med. 2013 Dec 3;159(11):I-32   [PMID:  24297209 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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