Background: Anamia confers an adverse prognosis in patients with ST elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including: inflammation, blood loss and the presence of co-morbidities such as renal failure. The aim of the present study was to evaluate the possible role of bone marrow dysfunction as a cause of anemia.
Materials and Methods: Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours from symptoms onset and who presented to our catheterization laboratory during a period of 36 months were included in the study. The cohort was divided into quartiles according to hemoglobin concentration and differences in clinical and laboratory characteristics between the groups were evaluated. Results: A total of 258 men with STEMI were recruited, 22% suffered from anemia according to the WHO classification (Hemoglobin 13 gr/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell (9.6±2.9 vs. 12.6±3.6 *103/µL, P0.001) and platelet counts (231±79 vs. 263±8 *103/µL, P0.01) despite higher inflammatory biomarkers (C - reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P=0.292).
Conclusion: Men with STEMI who are anemic have relatively lower leukocyte and platelet counts as well as an inadequate reticulocyte count despite higher inflammatory biomarkers. These findings might suggest bone marrow dysfunction.
