TY - JOUR
T1 - Impact of blood transfusion on in-hospital myocardial infarctions according to patterns of acute coronary syndrome: Insights from the BleeMACS registry
AU - Gili, Sebastiano
AU - D'Ascenzo, Fabrizio
AU - Lococo, Marco Francesco
AU - Moretti, Claudio
AU - Gaita, Fiorenzo
AU - Raposeiras-Roubín, Sergio
AU - Abu-Assi, Emad
AU - Henriques, Jose Paulo Simao
AU - Saucedo, Jorge
AU - González-Juanatey, José Ramón
AU - Wilton, Stephen B.
AU - Kikkert, Wouter J.
AU - Nuñez-Gil, Iván
AU - Ariza-Sole, Albert
AU - Song, Xiantao
AU - Alexopoulos, Dimitrios
AU - Liebetrau, Christoph
AU - Kawaji, Tetsuma
AU - Huczek, Zenon
AU - Nie, Shao-Ping
AU - Fujii, Toshiharu
AU - Correia, Luis
AU - Kawashiri, Masa-Aki
AU - García-Acuña, José María
AU - Southern, Danielle
AU - Alfonso, Emilio
AU - Terol, Belén
AU - Garay, Alberto
AU - Zhang, Dongfeng
AU - Chen, Yalei
AU - Xanthopoulou, Ioanna
AU - Osman, Neriman
AU - Möllmann, Helge
AU - Shiomi, Hiroki
AU - Scarano, Silvia
AU - Kowara, Michal
AU - Filipiak, Krzysztof
AU - Wang, Xiao
AU - Yan, Yan
AU - Fan, Jing-Yao
AU - Ikari, Yuji
AU - Nakahashi, Takuya
AU - Sakata, Kenji
AU - Yamagishi, Masakazu
AU - Kalpak, Oliver
AU - Kedev, Sasko
PY - 2016
Y1 - 2016
N2 - Blood transfusions (BTs) may worsen the prognosis of patients affected by acute coronary syndromes (ACS), although few data detail their impact on short-term events according to clinical presentation (ST Segment Elevation Myocardial Infarction, STEMI vs. Non-ST Segment Elevation ACS, NSTE-ACS). Patients undergoing percutaneous coronary intervention (PCI) for ACS, with data on BTs, were selected from the BleeMACS registry. The primary end point was the incidence of myocardial infarction during hospitalization (reAMI), the secondary end-points were 30-day mortality and the combined end-point of 30-day mortality and reAMI. Sensitivity analyses were performed according to clinical presentation (STEMI vs. NSTE-ACS). Overall, 13,975 patients were included: mean age was 64.1years, 10,651 (76.2%) were male and 7711 (55.2%) had STEMI. BTs were administered during hospitalization to 465 (3.3%) patients, who were older and presented a more relevant burden of risk factors. The primary end-point of reAMI occurred in 197 (1.4%) patients, of whom 102 (1.1%) with STEMI. After controlling for confounding variables, BTs independently predicted the primary end-point reAMI in patients admitted for STEMI (OR 4.059, 95% CI 2244-7.344) and not in those admitted for NSTE-ACS. Moreover, BTs independently related to 30-day mortality in STEMI and NSTE-ACS patients and to the composite of 30-day mortality and reAMI in STEMI patients. In patients undergoing PCI for ACS, BTs increase the risk of reAMI only in those admitted for STEMI, and not in those with NSTE-ACS. These results may help physicians to choose appropriate BT administration according to the admission diagnosis
AB - Blood transfusions (BTs) may worsen the prognosis of patients affected by acute coronary syndromes (ACS), although few data detail their impact on short-term events according to clinical presentation (ST Segment Elevation Myocardial Infarction, STEMI vs. Non-ST Segment Elevation ACS, NSTE-ACS). Patients undergoing percutaneous coronary intervention (PCI) for ACS, with data on BTs, were selected from the BleeMACS registry. The primary end point was the incidence of myocardial infarction during hospitalization (reAMI), the secondary end-points were 30-day mortality and the combined end-point of 30-day mortality and reAMI. Sensitivity analyses were performed according to clinical presentation (STEMI vs. NSTE-ACS). Overall, 13,975 patients were included: mean age was 64.1years, 10,651 (76.2%) were male and 7711 (55.2%) had STEMI. BTs were administered during hospitalization to 465 (3.3%) patients, who were older and presented a more relevant burden of risk factors. The primary end-point of reAMI occurred in 197 (1.4%) patients, of whom 102 (1.1%) with STEMI. After controlling for confounding variables, BTs independently predicted the primary end-point reAMI in patients admitted for STEMI (OR 4.059, 95% CI 2244-7.344) and not in those admitted for NSTE-ACS. Moreover, BTs independently related to 30-day mortality in STEMI and NSTE-ACS patients and to the composite of 30-day mortality and reAMI in STEMI patients. In patients undergoing PCI for ACS, BTs increase the risk of reAMI only in those admitted for STEMI, and not in those with NSTE-ACS. These results may help physicians to choose appropriate BT administration according to the admission diagnosis
U2 - https://doi.org/10.1016/j.ijcard.2016.07.075
DO - https://doi.org/10.1016/j.ijcard.2016.07.075
M3 - Article
C2 - 27404707
SN - 0167-5273
VL - 221
SP - 364
EP - 370
JO - International journal of cardiology
JF - International journal of cardiology
ER -