Researchers call for more studies evaluating how to treat stroke patients with anemia

More than three million people in the U.S. each year are diagnosed with anemia. Previous research has shown that the condition is independently associated with increased mortality in patients with chronic kidney disease, heart failure and acute coronary syndromes.

A recent study found that the presence of anemia might also lead to worse outcomes for stroke patients. The meta-analysis, published in the Journal of the American Heart Association, included more than 29,000 adults who suffered strokes.

Among patients who had an ischemic stroke, the presence of anemia was associated with a 97 percent increased risk of mortality. Of those with a hemorrhagic stroke, the presence of anemia was associated with a 46 percent increased risk of mortality.

Although this meta-analysis included patients from various countries and high-quality studies, the researchers acknowledged more work needed to be done before determining how to treat patients with anemia following their strokes.

“The optimal treatment option in this patient group is unclear,” they wrote. “Studies are required to examine the clinical and cost-effectiveness of interventions in this patient population in an acute stroke setting.”

The results added to the conflicting literature on stroke and anemia, which is characterized by a lack of healthy red blood cells or hemoglobin in the blood. The researchers noted that some early studies found no association between anemia and stroke outcomes, while others found low and high hemoglobin levels were associated with increased mortality.

It’s also unclear whether interventions for patients with anemia would improve their outcomes following strokes. The researchers mentioned that one observational study found patients with anemia and hemorrhagic stroke benefited from packed red blood cell transfusions, while another found the transfusions did not help. They also could not identify any studies that have evaluated the effect of packed red blood cell transfusions on patients with anemia and ischemic stroke.

“Because of the paucity of evidence, guidelines have been unable to specify hemoglobin targets or optimal management options,” the researchers wrote. “A randomized controlled trial is required to gauge the impact of transfusions and to establish optimum hemoglobin ranges in patients with acute stroke.”

Tim Casey,

Executive Editor

Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.

Around the web

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

Kate Hanneman, MD, explains why many vendors and hospitals want to lower radiology's impact on the environment. "Taking steps to reduce the carbon footprint in healthcare isn’t just an opportunity," she said. "It’s also a responsibility."