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Blood Transfusion in Elderly Patients with Acute Myocardial Infarction: Data From the RICO Survey.: Transfusion in Elderly with Myocardial Infarction.
Am J Med. 2017 Oct 10;:
Authors: Putot A, Zeller M, Perrin S, Beer JC, Ravisy J, Guenancia C, Robert R, Manckoundia P, Cottin Y
Abstract
BACKGROUND: Red blood cell transfusion benefit during acute myocardial infarction remains unclear in elderly. We aimed to assess the transfusion impact on 1-year mortality in acute myocardial infarction patients ≥ 65 y, according to their age and haemoglobin nadir.
METHODS: We included 3316 consecutive patients with acute myocardial infarction aged ≥ 65 y from the RICO survey. They were categorized according to their haemoglobin nadir (≤ 8, > 8 to ≤ 10 and > 10 g/dL) and age (< or ≥ 80 years).
RESULTS: 1906 patients (57%) were 65-79 y and 1410 (43%) ≥ 80 y, of whom 103 (5%) and 145 (10%) patients received red blood cell transfusion respectively (P < 0.001). In Cox regression analysis, transfusion was associated with increased 1-year mortality for haemoglobin nadir > 10 g/dL, but no significant effect for haemoglobin nadir between 8 and 10 g/dL. When haemoglobin nadir was ≤ 8g/dL, transfusion did not influence 1-year mortality for younger patients (65-79 y). However, for older patients (≥ 80 y), transfusion was associated with lower mortality (HR = 0.43 (0.22-0.86), P = 0.016).
CONCLUSION: Among older patients with acute myocardial infarction, the effect of transfusion was largely dependent on haemoglobin threshold and age. Transfusion was associated with increased 1-year mortality when haemoglobin nadir was > 10 g/dL. However, in patients aged ≥ 80 y with haemoglobin nadir < 8 g/dL, transfusion was associated with a 50% reduction in 1-year mortality.
PMID: 29030059 [PubMed - as supplied by publisher]