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Transfusion and mortality in patients with ST-segment elevation myocardial infarction treated with primary
E Marc Jolicoeur1, William W O'Neill, Anne Hellkamp
1Duke Clinical Research Institute, Box 3409, Durham, NC 27710, USA.
European Heart Journal
|July 15, 2009
Summary
Red blood cell transfusion is linked to higher 90-day mortality in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. However, this association may be confounded by other factors, warranting further investigation.
Area of Science:
- Cardiology
- Hematology
- Clinical Research
Background:
- Red blood cell transfusion is linked to increased mortality in acute coronary syndromes.
- Limited data exists on transfusion outcomes in contemporary ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).
Purpose of the Study:
- To investigate the association between red blood cell transfusion and 90-day mortality in STEMI patients treated with primary PCI.
Main Methods:
- Analysis of 5532 STEMI patients from the Assessment of Pexelizumab in Acute Myocardial Infarction trial.
- Multivariable logistic regression to identify transfusion predictors.
- Cox proportional hazards regression and landmark analyses to assess transfusion-mortality association.
Main Results:
- 3.9% of patients received red blood cell transfusion.
- Transfusion was significantly associated with increased 90-day mortality (HR=2.16; 95% CI: 1.20-3.88), even after adjusting for confounders.
- No significant difference in mortality hazard was observed among patients who survived to hospital discharge.
Conclusions:
- Red blood cell transfusion is associated with 90-day mortality in STEMI patients treated with primary PCI.
- Confounding factors likely contribute to the observed association.
- Further research is needed to clarify the complex relationship between transfusion, bleeding, and clinical outcomes.
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