Blood tests tied to anemia in heart attack patients

[Guest guest]

Blood draws for medical tests could make sick patients even sicker,

according to a new study that suggests drawing blood over and over may not

be as benign as once thought.

Earlier research has shown that as many as half of heart attack patients who

arrive at the hospital with normal hemoglobin levels go home with anemia,

often serious enough to cause symptoms.

" People who developed moderate anemia had more symptoms -- such as fatigue

and shortness of breath -- and actually had higher mortality after being

discharged from the hospital, " said Dr. Mikhail Kosiborod of Saint Luke's

Mid America Heart and Vascular Institute in Kansas City, Missouri.

" This doesn't prove that anemia causes the bad outcome but it certainly is a

risk factor, " he told Reuters Health.

To understand what was causing the blood loss leading to anemia, Dr.

Kosiborod and colleagues studied more than 17,000 heart attack patients at

57 U.S. hospitals.

All of them were admitted with normal blood counts, but one in five

developed moderate or severe anemia at the hospital.

Those patients turned out to have had an average of 174 mL of blood drawn,

whereas their peers who didn't experience anemia only had 84 mL drawn.

" Drawing blood in the hospital is very important, but we never thought there

was a downside, " said Dr. Kosiborod. " Now that we know there could be a

potential downside, it is important for doctors to critically consider if

the patients need the blood work. "

The new study, published in the Archives of Internal Medicine online August

8, didn't look at whether the blood tests were appropriate or not.

Although he stressed there is no bulletproof evidence, Dr. Kosiborod said

excessive blood tests now also appear to harm patients.

For every 50 mL of blood drawn, his team found, the risk of anemia climbed

by 18%. And there was a large variation between hospitals, indicating that

some might use the tests more liberally.

" What I tell patients is, they should expect to have their blood drawn in

the hospital, " he said.

But, he added, " it is perfectly fine for patients to ask doctors if frequent

blood work is necessary. "

His team is now looking at whether using smaller tubes to draw blood or

keeping samples for reuse could have an impact on anemia.

" The smaller-sized tubes are perfectly adequate for most of the tests we do

in the hospital, " Dr. Kosiborod said.

SOURCE: http://bit.ly/qBoKzT

Arch Intern Med 2011.

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