Blood Transfusion in Elderly Patients with Acute Myocardial Infarction: Data from the RICO Survey - 20/03/18
, Sophie Perrin, MD a, Jean-Claude Beer, MD c, Jack Ravisy, MD d, Charles Guenancia, MD, PhD c, Raphaël Robert, MD c, Patrick Manckoundia, MD, PhD a, e, Yves Cottin, MD, PhD b, cAbstract |
Background |
Red blood cell transfusion benefit during acute myocardial infarction remains unclear in the elderly. We aimed to assess the transfusion impact on 1-year mortality in acute myocardial infarction patients aged ≥65 years, according to their age and hemoglobin nadir.
Methods |
We included 3316 consecutive patients with acute myocardial infarction aged ≥65 years from the “obseRvatoire des Infarctus de Côte d'Or” (RICO) survey. They were categorized according to their hemoglobin nadir (≤8, >8 to ≤10, and >10 g/dL) and age (<80 or ≥80 years).
Results |
A total of 1906 patients (57%) were 65-79 years old, and 1410 (43%) were aged ≥80 years, of whom 103 (5%) and 145 (10%) patients received red blood cell transfusion, respectively (P < .001). In Cox regression analysis, transfusion was associated with increased 1-year mortality for hemoglobin nadir >10 g/dL but no significant effect for hemoglobin nadir between 8 and 10 g/dL. When hemoglobin nadir was ≤8 g/dL, transfusion did not influence 1-year mortality for younger patients (65-79 years). However, for older patients (≥80 years), transfusion was associated with lower mortality (hazard ratio 0.43 [95% confidence interval, 0.22-0.86], P = .016).
Conclusion |
Among older patients with acute myocardial infarction, the effect of transfusion was largely dependent on hemoglobin threshold and age. Transfusion was associated with increased 1-year mortality when hemoglobin nadir was >10 g/dL. However, in patients aged ≥80 years with hemoglobin nadir <8 g/dL, transfusion was associated with a 50% reduction in 1-year mortality.
Le texte complet de cet article est disponible en PDF.Keywords : Acute myocardial infarction, Anemia, Elderly, Mortality, Transfusion
Plan
| Funding: This work was supported by the University Hospital of Dijon, the Association de Cardiologie de Bourgogne, and by grants from the Agence Régionale de Santé de Bourgogne, Institut National de la Santé et de la Recherche Médicale, and from the Regional Council of Burgundy. |
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| Conflict of Interest: None. |
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| Authorship: All authors had access to the data and contributed to the writing of the manuscript. |
Vol 131 - N° 4
P. 422 - avril 2018 Retour au numéro
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