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Blood Transfusion in Elderly Patients with Acute Myocardial Infarction: Data from the RICO Survey

Abstract : 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 Cote 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.
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01857426
Contributeur : Caps - Université de Bourgogne <>
Soumis le : jeudi 16 août 2018 - 09:02:53
Dernière modification le : lundi 25 mai 2020 - 11:14:03

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Alain Putot, Marianne Zeller, Sophie Perrin, Jean-Claude Beer, Jack Ravisy, et al.. Blood Transfusion in Elderly Patients with Acute Myocardial Infarction: Data from the RICO Survey. The American Journal of Medicine, Elsevier [Commercial Publisher] 2018, 131 (4), pp.422 - 429.e4. ⟨10.1016/j.amjmed.2017.09.027⟩. ⟨hal-01857426⟩

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