Allonen J, et al. - Researchers conducted this trial to assess the impact of red blood cell (RBC) transfusion on long-term mortality among acute coronary syndrome (ACS) patients after 1-year follow-up. Findings suggested that even after 1-year follow-up, the strong relationship between the requirement for RBC transfusion and increased mortality continued for ACS patients.

Methods

• Herein experts followed the consecutive ACS patients (n =2009) of a prospective COROGENE-cohort for a median of 8.6 years (CI 95% 8.59 – 8.69).
• For over 30 days, 1,937 (96%) patients survived after discharge.
• Out of the survivors, they compared a subgroup of previously transfusion-naive patients 85/1,937 (4.4%), that had received at least 1 RBC transfusion during hospitalization to 1,278/1,937 (66.0%) patients, who had not received any transfusion either during the hospitalization or the entire follow-up.

Results

• Significantly higher unadjusted long-term mortality was noted among the RBC transfused patients vs their non-transfused counterparts (58.8% vs 20.3%, p < 0.001).
• Authors noted significant results for hazard ratio (HR) 1.91, 95% confidence intervals (CI) 1.39 – 2.63, p < 0.001 following multivariate Cox proportional hazards model analysis, and were similar after 1-year landmark analysis (HR 1.90, 95% CI 1.34 – 2.70, p < 0.001).
• Findings suggested that the higher all-cause mortality was largely explained by cancer- (15.3% vs 4.1%, p < 0.001) and cardiovascular mortality (34.1% vs 12.1%, p < 0.001).
• As per the data after 1:1 propensity score matching (n=65 vs 65), the relationship of RBC transfusion with worse survival remained significant (HR 2.70, 95% CI 1.48 – 4.95, p=0.001).
• Similar results were suggested by the inverse probability weighted Cox analyses (HR 2.07, 95% CI 1.38 – 3.11, p < 0.001).