title: Prognostic impact of red blood cell transfusion in patients undergoing primary angioplasty for ST elevation myocardial infarction.
abstract: OBJECTIVE
  We aimed to examine in-hospital and long-term outcomes of red blood cell (RBC) transfusions in patients undergoing a primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Overall, 2537 consecutive STEMI patients (mean age 56.2 ± 11.7 years, 2111 men, 426 women) undergoing primary angioplasty were enrolled retrospectively into the present study. Patients were categorized according to whether they received RBC transfusions during hospitalization. Clinical characteristics, and in-hospital and long-term outcomes of the primary PCI were analyzed.
  
  
  RESULTS
  Of the consecutive 2537 patients, 88 (3.4%) received RBC transfusions during the index hospitalization. The transfused patients were older than nontransfused patients (mean age 63.6 ± 12.1 vs. 56.2 ± 11.8, P<0.001). Compared with nontransfused patients, female sex and hypertension were more prevalent in transfused patients (45.4 vs. 15.8%, P<0.001; 52.3 vs. 40.7%, P=0.04, respectively). Baseline values of hematocrit and hemoglobin were lower in patients receiving transfusion (33 ± 6.2 vs. 40.2 ± 4.7%, P<0.001; 11.1 ± 2.3 vs. 13.7 ± 1.6 mg/dl, P<0.001, respectively). The transfused patients had significantly higher in-hospital and long-term mortality (for in-hospital mortality: 10.2 vs. 2.7%, P<0.001; for long-term mortality: 14.1 vs. 5.1%, P=0.001). By multivariate Cox regression analysis, in all 2537 patients, RBC transfusion was found to be a powerful independent predictor of in-hospital cardiovascular mortality (odds ratio 8.31, P<0.001).
  
  
  CONCLUSIONS
  These results show that RBC transfusion is associated with increased in-hospital and long-term mortality in patients with STEMI undergoing a primary PCI.
authors.affiliation: Department of Cardiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey. drmerg@hotmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Servet
authors.initials: S
authors.lastname: Altay
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.forename: Turgay
authors.initials: T
authors.lastname: Isik
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bacaksiz
authors.forename: Tuba
authors.initials: T
authors.lastname: Kemaloğlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gül
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cicek
authors.forename: Seref
authors.initials: S
authors.lastname: Kul
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ertas
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D004562:Electrocardiography; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology