Impact of blood transfusion on in-hospital myocardial infarctions according to patterns of acute coronary syndrome: Insights from the BleeMACS registry

Autor: Fabrizio D'Ascenzo, José P.S. Henriques, Masa-aki Kawashiri, Emilio Alfonso, Marco Francesco Lococo, Sergio Raposeiras-Roubín, Yan Yan, Krzysztof J. Filipiak, Claudio Moretti, Hiroki Shiomi, Luis C. L. Correia, Sebastiano Gili, Wouter J. Kikkert, Toshiharu Fujii, Shaoping Nie, Iván J. Núñez-Gil, Yalei Chen, Yuji Ikari, Danielle A. Southern, Dongfeng Zhang, José María García-Acuña, Tetsuma Kawaji, Alberto Garay, Neriman Osman, Jorge F. Saucedo, Zenon Huczek, Emad Abu-Assi, Stephen B. Wilton, Kenji Sakata, Xiantao Song, Helge Möllmann, Silvia Scarano, José Ramón González-Juanatey, Xiao Wang, Ioanna Xanthopoulou, Christoph Liebetrau, Fiorenzo Gaita, Takuya Nakahashi, Dimitrios Alexopoulos, Albert Ariza-Solé, Michal Kowara, Belén Terol, Jing-Yao Fan, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev
Přispěvatelé: Amsterdam Cardiovascular Sciences, Cardiology
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Acute coronary syndrome
Blood transfusion
International Cooperation
medicine.medical_treatment
Acute coronary syndromes
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Recurrence
Internal medicine
medicine
Clinical endpoint
Humans
ST segment
Blood Transfusion
Registries
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Acute Coronary Syndrome
Recurrent myocardial infarction
Non-ST Elevated Myocardial Infarction
business.industry
Unstable angina
Patient Selection
Transfusion Reaction
Percutaneous coronary intervention
Middle Aged
Prognosis
medicine.disease
Female
Follow-Up Studies
ST Elevation Myocardial Infarction
Cardiology and Cardiovascular Medicine
surgical procedures
operative
Conventional PCI
Cardiology
business
Zdroj: International journal of cardiology, 221, 364-370. Elsevier Ireland Ltd
ISSN: 0167-5273
Popis: Background 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). Methods 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). Results 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. Conclusions 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.
Databáze: OpenAIRE
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