Transfusion and clinical outcomes after percutaneous coronary intervention

Area of Science:

• Cardiology
• Transfusion Medicine
• Interventional Cardiology

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• The role and impact of blood transfusions on long-term outcomes following PCI require further investigation.

Purpose of the Study:

• To investigate the long-term patterns and clinical outcomes associated with blood transfusions in patients undergoing PCI.
• To assess the association between transfusion and major adverse clinical events (MACE) after PCI.

Main Methods:

• Analysis of a nationwide registry of Korean patients undergoing PCI with stenting in 2011 (n=48,786).
• Evaluation of 5-year clinical outcomes, focusing on the incidence density of transfusion.
• Propensity score adjustment to assess the association of transfusion with MACE (all-cause death, revascularization, critical cardiovascular status, stroke).

Main Results:

• The 5-year incidence density of transfusion was 4.74 per 100 person-years.
• Transfused patients were older with more clinical risk factors (p<0.001).
• Transfusion was significantly associated with increased MACE (HR 3.2) and other clinical events (HR 1.5-6.9, p<0.001).
• Within 5 years, 22.9% of patients received transfusions, experiencing a 3.2-fold higher MACE risk.

Conclusions:

• Blood transfusion after PCI is associated with a significantly higher risk of major adverse clinical events.
• The timing of transfusion correlates with periods of highest MACE incidence density.
• These findings highlight the importance of judicious transfusion strategies in PCI patients.