Blood transfusion and mortality in myocardial infarction: an updated meta-analysis

Abstract

Background Several observational and preclinical studies have shown that blood transfusion may modify the mortality of patients with myocardial infarction (MI). The aim of this meta-analysis is to evaluate the recent evidence on the effectiveness of blood transfusion for all-cause mortality in patients with MI. Materials and Methods PUBMED, EMBASE and the Cochrane central register of controlled trials were searched up to June 2016 by two independent investigators. Studies were considered eligible if they recruited adult MI patients and reported hazard ratio (HR) for all-cause mortality comparing those who received blood transfusion with those who did not receive blood transfusion. We abstracted and calculated pooled HRs using a random-effects model. Results From 4277 unique reports, we identified 17 studies including 260811 patients with 11 studies examining short-term (in hospital/30-day) all-cause mortality and 9 studies examining long-term (more than 30 days) all-cause mortality. Meta-analysis demonstrated that patients treated with blood transfusion had increased short-term all-cause mortality (HR, 2.39, 95% CI 1.81 to 3.15) compared with those without blood transfusion treatment. Similar findings were observed by subgroup analyses. We also find significant association between blood transfusion and long-term all-cause mortality (HR 1.90, 95% CI 1.40 to 2.58) for MI patients. Conclusions In patients with MI, blood transfusion treatment is associated with patient short-term and long-term all-cause mortality. However, further large-scale prospective studies are needed to establish its validity of this association.

RBC Transfusion Induced ST Segment Variability Following the Norwood Procedure

“…Numerous studies of critically ill adults and children have found an association between RBC transfusions and increased mortality and morbidity (1)(2)(3)(4). Although the storage lesion has been well documented for some time and our understanding of the mechanisms involved have increased substantially over the last several years, its role in disease and the clinical consequences remain to be determined (5)(6)(7)(8).…”

“…Patients with cardiac disease are transfused at higher hemoglobin thresholds than those without cardiac disease, and the management of cyanotic congenital heart disease often prompts practitioners to target even higher hemoglobin levels. RBC transfusions in cardiac patients are associated with adverse outcomes, including following the Norwood procedure (NP) for palliation of the hypoplastic left heart syndrome (HLHS) (1–4). There is increasing evidence that transfusion of stored RBCs reduces nitric oxide (NO) bioavailability, which may play a role in influencing the postoperative course and clinical outcomes (5–7).…”

“…following the Norwood procedure (NP) for palliation of the hypoplastic left heart syndrome (HLHS) (1)(2)(3)(4). There is increasing evidence that transfusion of stored RBCs reduces nitric oxide (NO) bioavailability, which may play a role in influencing the postoperative course and clinical outcomes (5)(6)(7).…”

Association between Anemia Severity and Ischemic Stroke Incidence: A Retrospective Cohort Study

“…In addition, accumulating evidence indicates that anemia engenders outcomes such as increased stroke [9], heart failure [33], hospitalization [25], and mortality [34], all of which impose a severe burden on healthcare systems. Furthermore, anemia is associated with increased iron overload, increased chances of viral infection [35], and increased risks of myocardial infarction [36]. We also analyzed other known conventional risk factors, such as hyperlipidemia and atrial fibrillation, that affect the development of stroke; the hazard ratio was slightly different to other investigations [9].…”

Effect of transplantation of cardiac stem cells overexpressing integrin‑linked kinase on cardiac function of rats with acute myocardial infarction

“…Zhong and Rao ( 18 ) studied and showed that after the treatment of ischemic cardiomyopathy with CSC transplantation therapy, the migration and proliferation capabilities of CSCs are superior, there are many new cells and blood vessels in the MI region, and cardiac function recovery is better. ILK can regulate intracellular signaling pathways and transmit extracellular signals into cells, thereby promoting cell survival, reducing apoptosis and promoting cell proliferation and differentiation ( 3 , 19 , 20 ).…”