Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - blood transfusions


 * ; ; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Blood Transfusions

 * Inicidence: 5-10% of NSTEMI patients receive blood transfusions.


 * Indication:
 * The appropriate use of blood transfusion administration is highly subjective due to lack of definitive data on transfusion triggers in patients with CAD. However, there is an association between transfusion and short-term mortality among NSTEMI patients.

Given this equipoise, it seems reasonable to conclude that routine use of transfusion to maintain arbitrary hemoglobin levels in asymptomatic patients should be avoided.
 * Clinical trial data:
 * Yang and colleagues analyzed data from 74,271 NSTEMI/unstable angina patients and found a significant association between blood transfusion and in-hospital mortality.
 * Wu and colleagues analyzed 78,974 elderly patients with acute MI and associated the reception of blood transfusion with a significant increased risk of 30-day death when baseline HCT was > 33%.
 * Rao and colleagues examined 24,111 NSTEMI patients and found that blood transfusion was associated with a significantly higher risk of 30-day mortality if the nadir HCT was > 24%.