在急性冠状动脉综合征的贫血患者中输血:基于人口的队列研究
Nikhil Mistry1, C David Mazer2, Atul Sivaswamy3
1Department of Anesthesia, St. Michael's Hospital, Toronto, Ontario, Canada.
The Canadian journal of cardiology
|October 20, 2024
概括
红细胞 (RBC) 输血可能有利于急性冠状动脉综合征 (ACS) 和中度贫血的住院患者. 输血与较低的死亡率和30天内心脏病入院率有关.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 临床医学 临床医学
背景情况:
- 在急性冠状动脉综合征 (ACS) 中,红细胞 (RBC) 输血对急性冠状动脉综合征 (ACS) 贫血的有效性存在争议.
- 重点是血红蛋白 (Hb) 水平接近或低于中度贫血范围的患者.
研究的目的:
- 评估红细胞输血与住院的中度贫血ACS患者的临床结果之间的关联.
- 研究输血对死亡和心肌梗塞 (MI) 复合终点的影响.
主要方法:
- 在加拿大安大略省 (2012-2021) 进行基于人口的队列研究.
- 包括因ACS住院的成年人,在医院内Hb的最低值为6.0-8.9g/dL.
- 使用重叠倾向得分权重来比较输血与非输血患者,不包括特定的患者群体.
- 主要结局:所有原因死亡和心脏病发作后30天内入院的综合结局.
主要成果:
- 这项研究包括7922名患者 (3498名接受了输血,4424名没有).
- 在倾向权重的队列中,Hb的平均最低点为7.75g/dL.
- 30天复合结局发生率为28.6% (输血) 和33.3% (没有输血) (HR,0.83;95% CI,0.75-0.91).
- 结果在1年后和所有灵敏度分析中持续存在.
结论:
- 在ACS患者中,红细胞输血与减少复合事件 (死亡/MI住院) 相关,Hb 6.0-8.9 g/dL.
- 研究结果表明,在这种特定患者群体中,输血可能有潜在的益处.
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