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Anemia is one of the most frequent comorbidities found in patients with coronary artery disease and chronic heart failure (CHF) who are being followed in cardiac rehabilitation facilities. The more frequent type of anemia is that caused by iron deficiency (IDA, iron-deficiency anemia): this review summarizes the state of the art of this topic. First of all, the mechanisms of IDA will be analyzed. Subsequently, a description of the main conditions where IDA can unfavorably affect the clinical course, and of its more frequent complications, will be presented (percutaneous interventions, heart surgery, CHF). Special attention will be paid in the description of anemia in the setting of CHF. To this regard, in recent years a relevant amount of research has been carried out, to determine whether treating anemia (either by directly stimulating erythropoiesis or by correcting iron deficiency by oral or intravenous route) is of any clinical and prognostic relevance in patients with CHF. The results of this research will therefore be summarized and critically discussed. Finally, we will outline the promising role of cardiac rehabilitation facilities and of its network of experts in the diagnosis, prognostic stratification and treatment of anemia and iron deficiency. [ABSTRACT FROM AUTHOR]

Coronary atherosclerotic disease is still one of the leading causes of death worldwide. Despite the changes of lifestyle and therapeutic treatments, there is an individual residual risk as worthy of further study. Investigating the residual risk means knowing its pathophysiological mechanisms, developing imaging techniques and biomarkers capable of identifying patients who can benefit from new available treatments. It is known that in all phases of the atherosclerotic process a pivotal role is played by inflammation, which, through innate and adaptive immunity, determines many direct and indirect effects which affect the patient's prognosis. The most immediate and least expensive way to stratify the patient's inflammatory risk is a dosage of high-sensitivity C-reactive protein (hs-CRP). The hs-CRP reduction and cardiovascular events observed with the use of lipid-lowering drugs (statins), in treatments aimed at modulating the inflammatory system in the treatment of rheumatological pathologies, has paved the way for studies with drugs in the rheumatological therapeutic arena in the cardiovascular setting. The results, in addition to confirming an improvement in the main cardiovascular hard endpoints, allowed a refinement of knowledge by identifying increasingly precise targets and reducing potential side effects. Ongoing and future studies are creating solid scientific evidence in which the optimal control of inflammation will be an essential therapeutic target.

Acute myocardial infarction, stroke, peripheral arterial disease and pulmonary embolism share thrombosis as a common mechanism. Some well-known risk factors for arterial thromboembolism are recognized as "weak risk factors" of venous one, too. Arterial and venous thrombosis share also some pathophysiological mechanisms, including inflammation, endothelial damage, and hypercoagulability. It is likely, thus, that any disease related to arterial and venous thrombosis belong to the same "pan-vascular syndrome", that constitutes itself a chronic, recurrent inflammatory disease. According to the available data, there are elements for implementing an omni-comprehensive cardiovascular evaluation after an episode of venous thromboembolism, requiring the investigations, in addition to the known unrecognized prothrombotic conditions, also of indirect signs and risk factors for a possible arterial thromboembolic event. Large, prospective studies are needed to establish the more appropriate therapeutic strategies in this context.The aim of the present statement is to make aware all the physicians involved in the management of arterial and venous diseases and to provide some tools for evaluating the implications of related major risk factors. Thus, it could be possible to lay the foundation for a reduction of total cardiovascular risk, in terms of primary and secondary prevention of arterial and venous thromboembolism.

Cardiac rehabilitation (CR) represents a cardiology subspecialty that is devoted to the care of cardiac patients, early and long term after an acute event. CR aims at improving both quality of life and prognosis through risk and prognostic stratification, clinical stabilization and optimization of therapy, management of comorbidities, treatment of disability, and the provision of sustained long-term preventive and rehabilitative services.The mission of CR has changed over time. From being centred on the acute phase, health care of cardiac patients is increasingly involving the long-term chronic phase. The aim of the present position paper is to provide the state of the art of CR in Italy, discussing strengths and weaknesses as well as future perspectives.