100.17 Liberal Versus Conservative Transfusion Strategy for Patients With Acute Myocardial Infarction and Anemia: A Systematic Review and Meta-Analysis
Recommended Citation
Al-Abdouh A, Sukhon F, Jabri A, Alameh A, Khader S, Villablanca P, Alqarqaz M. 100.17 Liberal Versus Conservative Transfusion Strategy for Patients With Acute Myocardial Infarction and Anemia: A Systematic Review and Meta-Analysis. JACC Cardiovasc Interv 2024; 17(4):S5.
Document Type
Conference Proceeding
Publication Date
2-1-2024
Publication Title
JACC Cardiovasc Interv
Abstract
Background: A goal hemoglobin (Hb) level of 7 or 8 d/dL has been standard of care across the medical field, below which blood transfusion is necessitated. The question of whether patients presenting with acute myocardial infarction (MI) may benefit from a more liberal transfusion strategy has been a topic of debate. We performed a meta-analysis of all trials that have aimed to answer this clinical question. Methods: We conducted a systematic review and meta-analysis including all available RCTs that compared a liberal versus a restrictive transfusion strategy for patient with acute MI presenting with anemia. The primary outcomes were recurrent MI and death or MI. Secondary outcomes included risk of stroke, revascularization, heart failure, and death from any cause. Given the small number of trials, we ran the analysis using the Paul-Mendele method with Hartung Knapp adjustment. Results: Four RCTs were included comprising a total of 2155 patients treated with a liberal transfusion strategy vs 2170 patients treated with a conservative transfusion strategy. Compared with a conservative transfusion strategy, liberal transfusion was not significantly associated with a reduction in MI (relative risk [RR] 0.85; 95% CI 0.72 - 1.02, p = 0.07) or death or MI (relative risk [RR] 0.88; 95% CI 0.45 - 1.71, p = 0.57). It also showed no difference in death from any cause (relative risk [RR] 0.82; 95% CI 0.25 - 2.68, p = 0.63), stroke (relative risk [RR] 0.89; 95% CI 0.48 - 1.64, p = 0.50), revascularization (relative risk [RR] 0.0.93; 95% CI 0.48 - 1.80, p = 0.68), or heart failure (relative risk [RR] 0.1.14; 95% CI 0.04 - 28.84, p = 0.88). Conclusion: Our meta-analysis further solidifies current medical practices of restricting transfusion of patients with acute MI to those with a Hb level of 7 or 8 g/dL, as more liberal transfusion strategies did not translate into improved clinical outcomes. [Formula presented]
Volume
17
Issue
4
First Page
S5
