scholarly journals Relation of Use of Red Blood Cell Transfusion After Acute Coronary Syndrome to Long-Term Mortality

2018 ◽  
Vol 121 (12) ◽  
pp. 1496-1504 ◽  
Author(s):  
Jaakko Allonen ◽  
Markku S. Nieminen ◽  
Seppo Hiippala ◽  
Juha Sinisalo
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Coronary Syndrome ◽  
Long Term Mortality

scholarly journals Limited effect of red blood cell transfusion on long-term mortality among anaemic cardiac surgery patients

2020 ◽  
Vol 31 (3) ◽  
pp. 375-382
Author(s):  
Long Tran ◽  
Guri Greiff ◽  
Alexander Wahba ◽  
Hilde Pleym ◽  
Vibeke Videm
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Blood Cell ◽  
Red Blood Cell ◽  
World Health ◽  
Red Blood Cell Transfusion ◽  
Rbc Transfusion ◽  
Long Term Mortality

Abstract OBJECTIVES Our goal was to investigate long-term mortality associated with red blood cell (RBC) transfusion among patients with anaemia undergoing cardiac surgery when adjusting for known risk factors. METHODS Adults with preoperative anaemia as defined by World Health Organization criteria undergoing open-heart surgery from 2000 through 2017 were included. Cox regression was performed for long-term mortality (30 days–5 years), comparing patients who received ≥1 unit of RBC with those who did not. Unadjusted and multivariable analyses adjusted for risk factors were performed. RESULTS The study included 1859 patients, 1525 (82%) of whom received RBC transfusion. A total of 370 (19.9%) deaths were registered between 30 days and 5 years; 88 patients (23.8%) died between 30 days and 1 year. The unadjusted hazard ratio (HR) associated with RBC transfusion was 2.09 (1.49–2.93, P < 0.001) from 30 days to 5 years postoperatively. The HR for RBC transfusion were 4.70 (1.72–12.81, P = 0.002) and 1.77 (1.23–2.55, P = 0.002) for 30 days–1 year and 1–5 years, respectively. Adjusting for perioperative risk factors, which included postoperative complications, the HR decreased to 1.16 (0.80–1.68, P = 0.43), 1.79 (0.63–5.12, P = 0.28) and 1.11 (0.75–1.65, P = 0.61) for observation time from 30 days to 5 years, 30 days to 1 year and 1 to 5 years, respectively. Results were similar when postoperative complications were excluded from the adjustment variables. CONCLUSIONS No statistically significant association between RBC transfusion and long-term mortality was found when we adjusted for known risk factors. This study suggests that the observed difference in mortality in this patient group is largely due to patient-related risk factors.

Impact of red blood cell transfusion on acute coronary syndrome: a meta-analysis

2016 ◽  
Vol 13 (2) ◽  
pp. 231-241 ◽  
Author(s):  
Yushu Wang ◽  
Xiuli Shi ◽  
Rongsheng Du ◽  
Yucheng Chen ◽  
Qing Zhang
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Meta Analysis ◽  
Red Blood Cell Transfusion ◽  
Coronary Syndrome

Blood Platelet Count at Hospital Admission Impacts Long-Term Mortality in Patients with Acute Coronary Syndrome

Cardiology ◽  
2020 ◽  
Vol 145 (3) ◽  
pp. 148-154 ◽  
Author(s):  
Artur Małyszczak ◽  
Agata Łukawska ◽  
Izabela Dyląg ◽  
Weronika Lis ◽  
Andrzej Mysiak ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Platelet Count ◽  
Mortality Rate ◽  
Hospital Admission ◽  
Cox Proportional Hazards Model ◽  
Distribution Width ◽  
Platelet Indices ◽  
Coronary Syndrome ◽  
Long Term Mortality

Introduction: Platelets play a fundamental role in the pathogenesis of acute coronary syndrome (ACS). The platelet count (PC) at hospital admission is easy to obtain, but whether thrombocytopenia or/and thrombocytosis impact long-term mortality (LTM) after ACS is unclear. Objective: To evaluate the effect of PC at hospital admission on LTM in patients with ACS. Methods: This retrospective cohort study included patients with the ICD-10 codes for unstable angina (I.20) and acute myocardial infarction (I.21, I.22). Thrombocytopenia was defined as a blood PC <150 G/L and thrombocytosis as a PC >450 G/L. Additional platelet indices which were tested included plateletcrit (PCT), the mean platelet volume (MPV), the platelet distribution width (PDW), and the platelet larger cell ratio (P-LCR). Data on all-cause death were obtained from the National Health Fund database. Results: The study included 3,162 patients with a median follow-up of 27.2 months (interquartile range 12.5–46.8 months; max 68.7 months). Patients with thrombocytopenia and thrombocytosis yielded a higher maximal analyzed 5-year mortality rate in comparison with normal PC patients (45.8 and 47.7 vs. 24.2%, respectively; p < 0.00001) which was mainly driven by higher deaths at 1–2 years after ACS. The 5-year LTM was also significantly higher in patients with abnormal PCT and MPV levels in comparison with patients with PCT and MPV within the normal range. Other platelet indices (PDW, P-LCR) were not associated with a worse outcome. The Cox proportional hazards model revealed that thrombocytopenia at admission was independently associated with higher LTM after ACS (RR 1.83; 95% CI 1.1–3.0; p = 0.01). Conclusions: Both thrombocytopenia and thrombocytosis at hospital admission in post-ACS patients are associated with a significant almost two times higher 5-year mortality rate.

Sign in / Sign up

Export Citation Format

Share Document