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Thalassemia and acute coronary syndromes

Published:November 30, 2015DOI:https://doi.org/10.1016/j.ejim.2015.11.014
      The recent report on “risk of coronary artery disease in transfusion-naïve thalassemia populations [
      • Chen Y.G.
      • Lin C.L.
      • Ho C.L.
      • Chen Y.C.
      • Kao C.H.
      Risk of coronary artery disease in transfusion-naïve thalassemia populations: a nationwide population-based retrospective cohort study.
      ]” is very interesting. In fact, thalassemia is a common congenital inherited hemoglobin disorder that is common in several parts of the world. Anemia is a common finding. As noted by Chen et al., increase risk of heart disease can be seen in case with thalassemia [
      • Chen Y.G.
      • Lin C.L.
      • Ho C.L.
      • Chen Y.C.
      • Kao C.H.
      Risk of coronary artery disease in transfusion-naïve thalassemia populations: a nationwide population-based retrospective cohort study.
      ]. Additional concern should be mentioned in thalassemic case that already gets the acute coronary syndrome. Anemia in acute coronary syndrome needs comprehensive care. Foussas noted that transfusion for correction of anemia in case with acute coronary syndrome should not be done due to the risk [
      • Foussas S.
      Acute coronary syndromes and anaemia.
      ]. However, in case of transfusion dependent thalassemic patient, the management of the case can be more difficult. Balancing between the requirement of blood transfusion due to anemic problem and risk of volumetric insult during acute coronary attack is very important. To manage those cases, multidisciplinary medical team approach is needed.
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      References

        • Chen Y.G.
        • Lin C.L.
        • Ho C.L.
        • Chen Y.C.
        • Kao C.H.
        Risk of coronary artery disease in transfusion-naïve thalassemia populations: a nationwide population-based retrospective cohort study.
        Eur J Intern Med. 2015 May; 26: 250-254
        • Foussas S.
        Acute coronary syndromes and anaemia.
        Hellenic J Cardiol. 2015 Sep-Oct; 56: 447-448