scholarly journals Beneficial effects of empagliflozin on hematocrit levels in a patient with severe anemia

Author(s):  
Jan Budzianowski ◽  
Janusz Rzeźniczak ◽  
Jarosław Hiczkiewicz ◽  
Dominika Kasprzak ◽  
Anna Winnicka-Zielińska ◽  
...  

Abstract Introduction Sodium-glucose cotransporter (SGLT2) inhibitors may additionally benefit patients with diabetes by improving their erythropoiesis followed by the elevation of hemoglobin and hematocrit levels. Reason for the report In the case described, severe normocytic normochromic anemia was resolved when empagliflozin had been introduced to the therapy. Case summary A 78-year-old male patient was admitted to our hospital with a non-ST-segment elevation myocardial infarction. His past medical history included diabetes, right coronary artery angioplasty, myocardial infarction and paroxysmal atrial fibrillation which required anticoagulant treatment. When examined, severe normocytic normochromic anemia was also diagnosed. About two years prior to his admission, the patient began suffering from persistent anemia despite the modification of his anticoagulant therapy with warfarin, rivaroxaban and dabigatran. An extensive evaluation failed to provide an explanation for his anemia. Outcome Eventually, only the introduction of empagliflozin successfully increased the values of hemoglobin and hematocrit. Therefore, it transpires that SGLT2 enhances erythropoietin (EPO) secretion which subsequently raises hematocrit levels in patients with severe anemia. Graphic abstract

2021 ◽  
Author(s):  
Ching-Hui Sia ◽  
Junsuk Ko ◽  
Huili Zheng ◽  
Andrew Ho ◽  
David Foo ◽  
...  

Abstract Smoking is one of the leading risk factors for cardiovascular diseases, including ischemic heart disease and hypertension. However, in acute myocardial infarction (AMI) patients, smoking has been associated with better clinical outcomes, a phenomenon termed the “smoker’s paradox.” Given the known detrimental effects of smoking on the cardiovascular system, it has been proposed that the beneficial effects of smoking on outcomes is due to age differences between smokers and non-smokers and is therefore a smoker’s pseudoparadox. The aim of this study was to evaluate the association between smoking status and clinical outcomes in ST-segment elevation (STEMI) and non-STEMI (NSTEMI) patients treated by percutaneous coronary intervention (PCI), using a national multi-ethnic Asian registry. In unadjusted analyses, current smokers had better clinical outcomes following STEMI and NSTEMI. However, after adjusting for age, the protective effect of smoking was lost, confirming a smoker’s pseudoparadox. Interestingly, although current smokers had increased risk for recurrent MI within 1 year after PCI in both STEMI and NSTEMI patients, there was no increase in mortality. In summary, we confirm the existence of a smoker’s pseudoparadox in a multi-ethnic Asian cohort of STEMI and NSTEMI patients and report increased risk of recurrent MI, but not mortality, in smokers.


Circulation ◽  
2017 ◽  
Vol 136 (6) ◽  
pp. 602-604 ◽  
Author(s):  
Gennaro Sardella ◽  
Massimo Mancone ◽  
Rocco Edoardo Stio ◽  
Erika Cavallo ◽  
Angelo Di Roma ◽  
...  

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