Transfusions for heart patients seen risky

Giving blood transfusions to anemic patients who are hospitalized with severe acute heart pain or a heart attack may increase their risk of dying, according to a new report.

Heart patients are more and more likely to be anemic these days because they undergo more invasive procedures and take more drugs to prevent blood clots.

"Many physicians, upon learning that their heart patients are anemic, will reflexively order a blood transfusion," Dr. Sunil V. Rao, at Duke University in Durham, North Carolina, comments in a University press release. Whether transfusions are helpful or not is unclear.

The investigators analyzed data pooled from three large international trials involving over 24,000 patients with so-called acute coronary syndromes - that is, an impending or actual heart attack. Ten percent of the patients were given blood transfusions while they were hospitalized.

As reported in this week's Journal of the American Medical Association, the 30-day mortality rate was 8 percent among those transfused versus 3 percent of those not transfused. The corresponding rates of heart attacks in the two groups were 25 percent versus 8 percent.

After adjusting for various factors, blood transfusions were associated with a nearly four-fold higher risk of dying.

Rao's group warns that their findings are not sufficient to prompt a change in clinical practice. "Rather, it should be considered as evidence that caution is warranted when making transfusion decisions," they write.

SOURCE: Journal of the American Medical Association, October 6, 2004.