Blood transfusion - patient information
Blood Transfusions Hike Risk for Some Heart Attack Patients
Anemic heart attack patients who receive blood transfusions may face a higher risk of death or a second heart attack, a new study suggests.
By Jaimie Dalessio Clayton
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WEDNESDAY, Dec. 26, 2012— Heart attack patients who receive blood transfusions for anemia appear to be more likely than those who don't to die or suffer a second heart attack, according to new research.
Some doctors order blood transfusions for heart attack patients with anemia to help deliver oxygen to the heart, according to the report on the new research, published in this week'sArchives of Internal Medicine. But lack of evidence — randomized trials — regarding benefits and risks of the practice leaves little medical guidance on whether or not to order the transfusions.
Led by Brown University's Saurav Chatterjee, MD, researchers conducted a meta-analysis of data on the practice gathered in 10 previous studies — nine observational studies and one small randomized trial — involving more than 203,300 patients. The patients had received "liberal" transfusions, restricted versions of the treatment, or no transfusions at all. Liberal transfusion patients were identified as having received two units of blood or more, or receiving a transfusion despite a close-to-normal red blood cell concentration level.
Risk of death, the researchers found, was 12 percent higher for people who received the liberal transfusions compared to those who did not. Additionally, liberal-transfusion recipients faced twice the odds of having another heart attack.
"What we found is that the possibility of real harm exists with transfusion," Dr. Chatterjee said in a release from Brown University. "It is practiced in emergency departments all across the United States. I think it is high time that we need to answer the question definitively with a randomized trial."
Chatterjee also said in the release that the findings are not meant to suggest transfusions should be avoided completely for heart attack patients with varying degrees of anemia. Doctors' clinical judgment remains important until guidelines can be established from research-driven evidence.
"Before a definitive trial is out there, we should be conservative, especially considering the high risk of harm," he said.
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