Background: Red blood cell transfusion (RBCT) is used in patients with coronary disease suffering from anemia, due to its influence on exacerbating ischemia. Conversely, RBCT might increase risk for myocardial infarction (MI) and death in hospitalized patients with acute coronary syndrome (ACS). Current guidelines suggest caution in RBCT with those patients. We sought to investigate the relation between RBCT and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI)
Methods: We analyzed data from our medical center PCI registry, including data from the blood bank. Analysis included comparison of the RCBT cohort to all other patients as well as a propensity score matched analysis, using multiple demographic and clinical variables, thus comparing RBCT patients to comparable non-RBCT patients. Primary endpoints were death, MI, target vessel revascularization (TVR) and coronary artery bypass graft (CABG).
Results: Out of 15,059 consecutive PCI procedures, in 442 (2.63%), patients received RBCT after the PCI. The RBCT cohort included more women (51.0% vs. 22.4%), was older (mean age 73.2 vs. 65.1 years), had more diabetes (53.7% vs. 44.1%), hypertension (83.5% vs. 75.5%), renal failure (52.2% vs. 18.1%), a higher rate of ACS (71.7% vs. 58.3%) and suffered more from shock or were after resuscitation (9.4% vs. 1.1%). Pre-PCI hemoglobin was lower (10.9 g/dL vs. 13.3 g/dL) and hemoglobin drop was higher (19% vs. 5%, p
Conclusions: Patients receiving RBCT in our medical center represent a high risk cohort. In those patients, RBCT does not have a detrimental effect on short or long-term clinical outcomes.
