A meta-analysis involving ten studies has found that there
was an increased incidence of all-cause mortality in those patients who had
received a blood transfusion while being treated for myocardial infarction, or
Therapeutic methods, such as anticoagulation and anti
platelet drugs, have truly been outstanding in treating and improving the
clinical outcomes of coronary syndrome. Nevertheless, they are also capable of
increasing the risk for bleeding, leading to anemia in patients during their
hospital stay, making blood transfusion necessary.
Saurav Chatterjee, MD, of Brown University and Providence
Veterans Affairs Medical Center, Rhode Island, and his colleagues, carried out
a review of studies published during the period between January 1966 and March
Ten studies, comprising 203,665 subjects, were included for
analysis. All studies were observational, while just a single study was a
randomized trial. The analysis was carried out to assess the effect of blood
transfusion in myocardial infarction (heart attack) patients as against no
blood transfusion during myocardial infarction. It was found that there was a
death risk increase by 12 percent in the former.
Other statistical studies revealed that blood transfusion was linked to a higher
risk for death
and this was independent of baseline or nadir hemoglobin
level or any other change in hemoglobin level during the patient's stay in the
hospital. Blood transfusion is also a
risk factor for subsequent heart attack
, the study showed.
The study published online by the Archives of Internal
Medicine, a publication of the JAMA Network, concluded that the risks for
all-cause mortality and subsequent myocardial infarction are notably greater in
acute myocardial infarction patients getting a blood transfusion.
Jeffrey L. Carson at the University of Medicine
and Dentistry of New Jersey, and Paul C. Hébert at the Ottawa Hospital Research
Institute, Canada, however, are not very convinced. According to them, 'The authors remind us that patients with an acute
myocardial infarction are often anemic and receive red blood cell transfusion.
However, because of its many limitations, as physicians, we should not use the
results of this review to justify or limit the use of red blood cells'.