Prognostic impact of red blood cell transfusion in patients undergoing primary angioplasty for ST elevation myocardial infarction

Abstract

Objectives We aimed to examine in-hospital and long-term outcomes of red blood cell (RBC) transfusions in patients undergoing a primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Methods Overall, 2537 consecutive STEMI patients (mean age 56.2 +/- 11.7 years, 2111 men, 426 women) undergoing primary angioplasty were enrolled retrospectively into the present study. Patients were categorized according to whether they received RBC transfusions during hospitalization. Clinical characteristics, and in-hospital and long-term outcomes of the primary PCI were analyzed. Results Of the consecutive 2537 patients, 88 (3.4%) received RBC transfusions during the index hospitalization. The transfused patients were older than nontransfused patients (mean age 63.6+/-12.1 vs. 56.2+/-11.8, P<0.001). Compared with nontransfused patients, female sex and hypertension were more prevalent in transfused patients (45.4 vs. 15.8%, P<0.001; 52.3 vs. 40.7%, P=0.04, respectively). Baseline values of hematocrit and hemoglobin were lower in patients receiving transfusion (33+/-6.2 vs. 40.2+/-4.7%, P<0.001; 11.1+/-2.3 vs. 13.7+/-1.6 mg/dl, P<0.001, respectively). The transfused patients had significantly higher in-hospital and long-term mortality (for in-hospital mortality: 10.2 vs. 2.7%, P<0.001; for long-term mortality: 14.1 vs. 5.1%, P=0.001). By multivariate Cox regression analysis, in all 2537 patients, RBC transfusion was found to be a powerful independent predictor of in-hospital cardiovascular mortality (odds ratio 8.31, P<0.001).