Blood Transfusions and Heart-Attack Patients

Although blood transfusions are customarily given to anemic heart-attack patients in emergency rooms, the practice could actually increase the risk of death.

Researchers at Brown University analyzed the cases of more than 203,000 patients who had taken part in ten studies.  The patients had received either “liberal” transfusions of blood, or more moderate transfusions, or none at all. The researchers classified “liberal” transfusions as those with two or more units of blood, or had a reading of red blood concentration of higher than 30 percent.  That percentage is close to normal.

The risk of death, the researchers found, was 12 percent higher among those who had liberal transfusions when compared with those who didn’t. And the risk of having another heart attack was twice that for the liberal-transfusion group.

Lead author Saurav Chatterjee, a cardiology fellow at Brown, said that physicians were required to make a tough decision, since some heart attacks are accompanied by excessive ongoing bleeding. But the transfusion can also cause blood clotting, or an autoimmune response that sees the transfusion as an invader.

Chatterjee emphasized that the study results didn’t mean there should be an end to liberal transfusions, but only that doctors should think about reducing the amount of blood administered. He also said that a further, randomized trial is needed.

“Before a definitive trial is out there, we should be conservative, especially considering the high risk of harm,” Chatterjee said.

The Centre for Clinical Intervention Research, Maimonedes Medical Center, and Texas Tech University also collaborated on the study

The findings were published in the Archives of Internal  Medicine.