Relation of Use of Red Blood Cell Transfusion After Acute Coronary Syndrome to Long-Term Mortality

Allonen, Jaakko; Nieminen, Markku S.; Hiippala, Seppo; Sinisalo, Juha

doi:10.1016/j.amjcard.2018.02.035

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…This applies both to short-term and long-term mortality [3,[5][6][7][8]. A similar trend has been found not only after cardiac surgery but also after acute coronary syndrome [9,10]. In some studies, a higher impact on mortality has been observed in low-risk patients [6].…”

Section: Introductionsupporting

confidence: 60%

Sex Differences in Red Blood Cell Transfusions and 30-Day Mortality in Cardiac Surgery: A Single Center Observational Study

Räsänen,

Ellam,

Hartikainen

et al. 2023

JCM

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In cardiac surgery, women have higher short-term mortality and a higher risk of receiving red blood cell (RBC) transfusions than men. This study’s aim was to evaluate possible sex differences in RBC transfusions in cardiac surgery and their association with preoperative hemoglobin levels, body mass index, and 30-day mortality. A single-center retrospective study was conducted with 1583 patients (1181 men and 402 women) undergoing cardiac surgery. A total of 64.4% of the women and 33.0% of the men received an RBC transfusion. In a multivariable analysis, female sex was an independent predictor of RBC transfusion (OR 3.88, 95% CI 2.95–5.11, p < 0.001). Other independent predictors of RBC transfusion were age, preoperative hemoglobin level, and body mass index. The women were more likely to receive RBC transfusions than the men, regardless of the type of cardiac surgery. Decreased transfusion risk was found in all higher-than-normal weight categories in the women, but only in the severe obesity category in the men. Preoperative hemoglobin was similarly associated with RBC transfusion in the men and women. The crude 30-day mortality rate was higher in the women than in the men (2.5% vs. 0.9%, p = 0.018). In both sexes, RBC transfusion was associated with an increased probability of death within 30 days.

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Section: Introductionsupporting

confidence: 60%

Sex Differences in Red Blood Cell Transfusions and 30-Day Mortality in Cardiac Surgery: A Single Center Observational Study

Räsänen,

Ellam,

Hartikainen

et al. 2023

JCM

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“…The amount of transfusion in our matched cohort (median: 2; IQR: 2-4 units) was lower than that previously reported in patients with AMI (median: 8; IQR: 4-17.5 units). 23) Blood transfusions have been implicated in dose-dependent adverse effects. 24) Second, there are differences in the nature of the diseases.…”

Section: Discussionmentioning

confidence: 99%

Impact of Red Blood Cell Transfusion on Subsequent Cardiovascular Events in Patients with Acute Heart Failure and Anemia

Watanabe,

Tara,

Nishino

et al. 2024

Int. Heart J.

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Red blood cell (RBC) transfusion therapy is often performed in patients with acute heart failure (AHF) and anemia; however, its impact on subsequent cardiovascular events is unclear. We examined whether RBC transfusion influences major adverse cardiovascular events (MACE) after discharge in patients with AHF and anemia.We classified patients with AHF and anemia (nadir hemoglobin level < 10 g/dL) according to whether they received RBC transfusion during hospitalization. The endpoint was MACE (composite of all-cause death, nonfatal acute coronary syndrome/stroke, or heart failure readmission) 180 days after discharge. For survival analysis, we used propensity score matching analysis with the log-rank test. As sensitivity analysis, we performed inverse probability weighting analysis and multivariable Cox regression analysis.Among 448 patients with AHF and anemia (median age, 81 years; male, 55%), 155 received RBC transfusion and 293 did not. The transfused patients had worse clinical features than the non-transfused patients, with lower levels of nadir hemoglobin and serum albumin and a lower estimated glomerular filtration rate. In the propensity-matched cohort of 87 pairs, there was no significant difference in the MACE-free survival rate between the 2 groups (transfused, 73.8% vs. non-transfused, 65.3%; P = 0.317). This result was consistent in the inverse probability weighting analysis (transfused, 76.0% vs. non-transfused, 68.7%; P = 0.512), and RBC transfusion was not significantly associated with post-discharge MACE in the multivariable Cox regression analysis (adjusted hazard ratio: 1.468, 95% confidence interval: 0.976-2.207; P = 0.065).In conclusion, this study suggests that RBC transfusions for anemia may not improve clinical outcomes in patients with AHF.

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“…However, a transfusion appeared to have beneficial or neutral effects on mortality at Hb levels below 8.0 g/dL, and harmful effects above 10 g/dL. [13,14] The symptoms of chronic anemia are tiredness, weakness, headache, vertigo, angina, exercise intolerance, and dyspnea. The underlying cause is most likely iron deficiency anemia or anemia based on other nutritional deficiencies.…”

Section: Discussionmentioning

confidence: 99%

How Urgent are the Blood Transfusions in the Emergency Service?

Özgür¹

2018

South Clin Ist Euras

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Objective: A blood transfusion, defined as a procedure to replace lost blood, is actually a tissue transplantation, performed with consideration given to the impact profile, the potential development of complications, and the risk of anaphylaxis and rejection, which may lead to death. This study is an analysis of emergency blood transfusions in terms of symptoms and indications.Methods: Hospital records of blood transfusions administered in the emergency service were retrospectively reviewed. The patients were categorized into 2 groups: emergency patients and non-emergency patients, based on the presentation.Results: Over the course of 3 months, 1156 transfusions (2.18 per person) were performed in 528 patients (61.4% male). It was determined that the most commonly seen patient complaints were weakness (19%) and melena (14%), followed by cases in which the patient was asymptomatic, but there was laboratory pathology (12.9%). In all, 47% of all cases of blood transfusion were considered urgent. Conclusion:No correlation was determined between urgency requirement and hemoglobin level. Aside from those administered for active bleeding, most blood transfusions were not performed due to an urgent indication. The establishment of separate, ambulatory parenteral treatment units in could reduce the burden on emergency services to some extent and protect the priority status real emergency patients need.

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Relation of Use of Red Blood Cell Transfusion After Acute Coronary Syndrome to Long-Term Mortality

Cited by 5 publications

References 24 publications

Sex Differences in Red Blood Cell Transfusions and 30-Day Mortality in Cardiac Surgery: A Single Center Observational Study

Sex Differences in Red Blood Cell Transfusions and 30-Day Mortality in Cardiac Surgery: A Single Center Observational Study

Impact of Red Blood Cell Transfusion on Subsequent Cardiovascular Events in Patients with Acute Heart Failure and Anemia

How Urgent are the Blood Transfusions in the Emergency Service?

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