For patients with acute myocardial infarction, a strategy of blood transfusion is associated with increased all-cause mortality and subsequent myocardial infarction compared with a strategy of no transfusion, according to a meta-analysis published online Dec. 24 in the Archives of Internal Medicine.
Saurav Chatterjee, MD, from Brown University and the Providence Veterans Affairs Medical Center in Rhode Island, and colleagues conducted a systematic review of the literature, including data from 10 studies, to examine the benefit of blood transfusion in patients with myocardial infarction.
The researchers found that a strategy of blood transfusion versus no transfusion correlated with increased all-cause mortality (risk ratio, 2.91), with a weighted absolute 12 percent increase in risk and a number needed to harm of eight. After adjustment for multivariates, the increased risk of mortality seen with blood transfusion was found to be independent of baseline hemoglobin level, nadir hemoglobin level, and change in level of hemoglobin during hospitalization. There was also a significant correlation between blood transfusion and the risk of subsequent myocardial infarction (risk ratio, 2.04).
"In conclusion, this meta-analysis provides evidence that rates of all-cause mortality and subsequent myocardial infarction are significantly higher in patients with acute myocardial infarction receiving blood transfusion," the authors write. "Additional outcomes data are needed from randomized clinical trials that investigate important outcomes with adequate sample size and with low risk for bias."
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