Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis

Background: Red blood cell transfusion can cause fluid overload. We evaluated the interaction between heart failure (HF) at baseline and transfusion strategy on outcomes in acute myocardial infarction (AMI). Methods: We used data from the randomized REALITY trial. HF was defined as history of HF or...

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Autores: Ducrocq, Gregory, Cachanado, Marine, Simon, Tabassome, Puymirat, Etienne, Lemesle, Gilles, Lattuca, Benoit, Ariza Solé, Albert, Silvain, Johanne, Ferrari, Emile, Gonzalez Juanatey, Jose R., Martínez Sellés, Manuel, Lermusier, Thibault, Coste, Pierre, Vanzetto, Gerald, Cottin, Yves, Dillinger, Jean G., Calvo Rojas, Gonzalo, Steg, Philippe Gabriel, REALITY Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/216595
Acceso en línea:https://hdl.handle.net/2445/216595
Access Level:acceso abierto
Palabra clave:Infart de miocardi
Anèmia
Transfusió de sang
Insuficiència cardíaca
Myocardial infarction
Anemia
Blood transfusion
Heart failure
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spelling Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup AnalysisDucrocq, GregoryCachanado, MarineSimon, TabassomePuymirat, EtienneLemesle, GillesLattuca, BenoitAriza Solé, AlbertSilvain, JohanneFerrari, EmileGonzalez Juanatey, Jose R.Martínez Sellés, ManuelLermusier, ThibaultCoste, PierreVanzetto, GeraldCottin, YvesDillinger, Jean G.Calvo Rojas, GonzaloSteg, Philippe GabrielREALITY InvestigatorsInfart de miocardiAnèmiaTransfusió de sangInsuficiència cardíacaMyocardial infarctionAnemiaBlood transfusionHeart failureBackground: Red blood cell transfusion can cause fluid overload. We evaluated the interaction between heart failure (HF) at baseline and transfusion strategy on outcomes in acute myocardial infarction (AMI). Methods: We used data from the randomized REALITY trial. HF was defined as history of HF or Killip class > 1 at randomization. Primary outcome was major adverse cardiovascular events (MACE): composite of all-cause death, nonrecurrent AMI, stroke, or emergency revascularization prompted by ischemia at 30 days. Results: Among 658 randomized patients, 311 (47.3%) had HF. Patients with HF had higher rates of MACE at 30 days and 1 year and higher rates of nonfatal new-onset HF. There was no interaction between HF and effect of randomized assignment on the primary outcome or nonfatal new-onset HF. A liberal transfusion strategy was associated with increased all-cause death at 30 days and at 1 year in patients with HF (P-interaction = 0.009 and P = 0.049, respectively). The main numerical difference in cause of death between restrictive and liberal strategies was death by HF at 30 days (4 vs 11). Conclusions: HF is frequent in patients with AMI and anemia and is associated with higher risk of MACE (including all-cause death) and nonfatal new-onset HF. Although there was no interaction of HF with effect of transfusion strategy on MACE, a liberal transfusion strategy was associated with higher all-cause death that appears driven by a higher risk of early death caused by HF.Elsevier BV2024202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/216595Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.cjca.2024.02.013Canadian Journal of Cardiology, 2024, vol. 40, num. 9, p. 1705-1714https://doi.org/10.1016/j.cjca.2024.02.013cc-by (c) Ducrocq, Gregory et al., 2024http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2165952026-05-29T05:05:01Z
dc.title.none.fl_str_mv Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
title Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
spellingShingle Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
Ducrocq, Gregory
Infart de miocardi
Anèmia
Transfusió de sang
Insuficiència cardíaca
Myocardial infarction
Anemia
Blood transfusion
Heart failure
title_short Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
title_full Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
title_fullStr Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
title_full_unstemmed Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
title_sort Restrictive vs Liberal Blood Transfusions for Patients With Acute Myocardial Infarction and Anemia by Heart Failure Status: An RCT Subgroup Analysis
dc.creator.none.fl_str_mv Ducrocq, Gregory
Cachanado, Marine
Simon, Tabassome
Puymirat, Etienne
Lemesle, Gilles
Lattuca, Benoit
Ariza Solé, Albert
Silvain, Johanne
Ferrari, Emile
Gonzalez Juanatey, Jose R.
Martínez Sellés, Manuel
Lermusier, Thibault
Coste, Pierre
Vanzetto, Gerald
Cottin, Yves
Dillinger, Jean G.
Calvo Rojas, Gonzalo
Steg, Philippe Gabriel
REALITY Investigators
author Ducrocq, Gregory
author_facet Ducrocq, Gregory
Cachanado, Marine
Simon, Tabassome
Puymirat, Etienne
Lemesle, Gilles
Lattuca, Benoit
Ariza Solé, Albert
Silvain, Johanne
Ferrari, Emile
Gonzalez Juanatey, Jose R.
Martínez Sellés, Manuel
Lermusier, Thibault
Coste, Pierre
Vanzetto, Gerald
Cottin, Yves
Dillinger, Jean G.
Calvo Rojas, Gonzalo
Steg, Philippe Gabriel
REALITY Investigators
author_role author
author2 Cachanado, Marine
Simon, Tabassome
Puymirat, Etienne
Lemesle, Gilles
Lattuca, Benoit
Ariza Solé, Albert
Silvain, Johanne
Ferrari, Emile
Gonzalez Juanatey, Jose R.
Martínez Sellés, Manuel
Lermusier, Thibault
Coste, Pierre
Vanzetto, Gerald
Cottin, Yves
Dillinger, Jean G.
Calvo Rojas, Gonzalo
Steg, Philippe Gabriel
REALITY Investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Infart de miocardi
Anèmia
Transfusió de sang
Insuficiència cardíaca
Myocardial infarction
Anemia
Blood transfusion
Heart failure
topic Infart de miocardi
Anèmia
Transfusió de sang
Insuficiència cardíaca
Myocardial infarction
Anemia
Blood transfusion
Heart failure
description Background: Red blood cell transfusion can cause fluid overload. We evaluated the interaction between heart failure (HF) at baseline and transfusion strategy on outcomes in acute myocardial infarction (AMI). Methods: We used data from the randomized REALITY trial. HF was defined as history of HF or Killip class > 1 at randomization. Primary outcome was major adverse cardiovascular events (MACE): composite of all-cause death, nonrecurrent AMI, stroke, or emergency revascularization prompted by ischemia at 30 days. Results: Among 658 randomized patients, 311 (47.3%) had HF. Patients with HF had higher rates of MACE at 30 days and 1 year and higher rates of nonfatal new-onset HF. There was no interaction between HF and effect of randomized assignment on the primary outcome or nonfatal new-onset HF. A liberal transfusion strategy was associated with increased all-cause death at 30 days and at 1 year in patients with HF (P-interaction = 0.009 and P = 0.049, respectively). The main numerical difference in cause of death between restrictive and liberal strategies was death by HF at 30 days (4 vs 11). Conclusions: HF is frequent in patients with AMI and anemia and is associated with higher risk of MACE (including all-cause death) and nonfatal new-onset HF. Although there was no interaction of HF with effect of transfusion strategy on MACE, a liberal transfusion strategy was associated with higher all-cause death that appears driven by a higher risk of early death caused by HF.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/216595
url https://hdl.handle.net/2445/216595
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.cjca.2024.02.013
Canadian Journal of Cardiology, 2024, vol. 40, num. 9, p. 1705-1714
https://doi.org/10.1016/j.cjca.2024.02.013
dc.rights.none.fl_str_mv cc-by (c) Ducrocq, Gregory et al., 2024
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Ducrocq, Gregory et al., 2024
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423193649840128
score 15.812429

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