Red-Cell Transfusion After Heart Attack Called Potentially Lethal

PHILADELPHIA, Oct. 27 -- Packed red cell transfusions in patients after myocardial infarction may increase the risk of serious arrhythmic events, often leading to death, said a researcher here.

Lethal cardiac events including ventricular tachycardia and cardiac arrest were more than twice as common in patients given the infusions, reported M. Kamran Athar, M.D., of Cooper University Hospital in Camden, N.J. The data emerged in a retrospective analysis, after adjusting for several risk factors known to affect MI outcomes.
Non-lethal events were increased nearly five-fold in transfused versus non-transfused patients. In-hospital mortality and duration of stay were also substantially greater in the transfused patients, he said.
Speaking at the American College of Chest Physicians meeting here, Dr. Athar said the findings supported "a more restrictive transfusion strategy in the setting of acute MI."
The practice of giving transfusions to patients following a heart attack is long-standing but has become controversial in recent years. Several studies have suggested that it increases mortality.
Dr. Athar said that atrial fibrillation related to packed red cell transfusions has been documented in cardiac surgical patients, but whether it also occurs in the context of acute MI had not been studied.
He and his colleagues reviewed records of 1,496 patients treated at Cooper University Hospital from 2003 to 2007, 148 of them given packed red cell transfusions.