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Updated: Mar 10, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Impact of transfusion on stroke after cardiovascular interventions: Meta-analysis of comparative studies
Debora Brascia1, Noemi Garcia-Medina1, Eeva-Maija Kinnunen1
1Department of Surgery, Oulu University Hospital, Oulu, Finland.
Insights
Blood transfusion increases stroke risk after cardiovascular procedures. Patients receiving transfusions had a 2.56 times higher risk of postoperative stroke compared to those not transfused.
Area of Science:
- Cardiovascular Medicine
- Transfusion Medicine
- Neurology
Background:
- Cardiovascular interventions carry inherent risks, including stroke.
- The role of blood transfusion in modulating post-procedural stroke risk is not fully elucidated.
Purpose of the Study:
- To evaluate the impact of blood transfusion on the development of stroke after cardiovascular interventions.
- To synthesize evidence from comparative studies on transfusion and post-procedural stroke.
Main Methods:
- A comprehensive literature search identified comparative studies.
- Meta-analysis and leave-one-out analyses were performed on data from 24 studies.
- Included studies involved adult cardiac surgery and interventional cardiology procedures.
Main Results:
- Transfused patients (2.1%) had a significantly higher risk of postoperative stroke than non-transfused patients (0.9%) (RR, 2.563).
- This association was consistent across interventional cardiology (RR, 3.325) and cardiac surgery (RR, 2.260) subgroups.
- Transfusion was identified as an independent predictor of stroke (RR, 1.53).
Conclusions:
- Blood transfusion is significantly associated with an increased risk of postoperative stroke in patients undergoing cardiovascular interventions.
- These findings highlight a potential modifiable risk factor for stroke in this patient population.
Purpose:
To evaluate the impact of transfusion on the development of stroke after cardiovascular interventions.
Methods:
A literature search was performed to identify comparative studies on the impact of blood transfusion on the occurrence of stroke after adult cardiac surgery and interventional cardiology procedures.
Results:
Twenty-four studies compared the outcome of 80 283 patients who received and 2 260 709 patients who did not receive blood transfusion after cardiovascular interventions. Pooled analysis showed that transfused patients had a higher risk of postoperative stroke (2.1% vs 0.9%; P < .001; risk ratio [RR], 2.563; 95% confidence interval [CI], 1.615-4.069; I2 = 94%) compared with patient who did not receive blood transfusion. The leave-one-out analysis confirmed the consistency of the overall series (RR ranged from 2.367 [95% CI, 1.978-2.834] to 2.676 [95% CI, 1.679-4.265]). Transfusion was associated with increased risk of stroke after either interventional cardiology interventions (3.2% vs 1.1%; RR, 3.325; 95% CI, 1.579-7.004) or cardiac surgery (1.9% vs 0.8%; RR, 2.260; 95% CI, 1.845-2.769). Generic inverse variance analysis of 11 studies reporting adjusted odds ratios for baseline characteristics showed that transfusion after cardiovascular interventions was an independent predictor of stroke (RR, 1.53; 95% CI, 1.10-2.14; I2 = 0%).
Conclusion:
Blood transfusion is associated with a significantly increased risk of postoperative stroke in patients undergoing cardiovascular interventions.
Registration:
The present meta-analysis is registered in PROSPERO, code CRD42016046426.
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