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(Circulation. 2001;104:e9040.)
© 2001 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

Transfusing Elderly Heart Attack Patients

Blood transfusions can reduce short-term mortality among elderly heart attack patients whose admission hematocrit is 30% and may even help those with a hematocrit as high as 33%, according to researchers from Brown University Medical School and Yale University School of Medicine (N Engl J Med. 2001;345:1230–1236).

The report in the October 25, 2001, issue of the New England Journal of Medicine was designed to answer the questions about whether transfusion could help elderly patients with myocardial infarction and at what level of anemia. In the study, researchers, who were led by Wen Chih Wu, MD, of the Division of Cardiovascular Diseases at Brown University Medical School in Providence, RI, evaluated the care of 78 974 Medicare patients in the Cooperative Cardiovascular Project who were categorized according to their admission hematocrit. They found that patients who had lower hematocrit values on admission had higher 30-day mortality rates. Blood transfusion reduced the 30-day mortality rates in patients with hematocrits as high as 33%. However, blood transfusion was associated with higher 30-day death rates in patients with admission hematocrits 36.1%.

"Although our study indicates that there is an overall benefit of transfusion in patients with acute myocardial infarction and anemia, patients who received transfusion despite the fact that their hematocrit values on admission were >36% had a higher risk of death within 30 days than patients with similar hematocrit values who did not receive transfusions," the authors wrote. "Very few patients with hematocrit values in this category received transfusions, and . . . [Full Text of this Article]