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The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative.

Publication ,  Journal Article
Yang, X; Alexander, KP; Chen, AY; Roe, MT; Brindis, RG; Rao, SV; Gibler, WB; Ohman, EM; Peterson, ED; CRUSADE Investigators,
Published in: J Am Coll Cardiol
October 18, 2005

OBJECTIVES: In a large contemporary population of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), we sought to describe blood transfusion rates (overall and in patients who did not undergo coronary artery bypass grafting [CABG]), patient characteristics and practices associated with transfusion, variation among hospitals, and in-hospital outcomes in patients receiving transfusions. BACKGROUND: The use of antithrombotic agents and invasive procedures reduces ischemic complications but increases risks for bleeding and need for blood transfusion in patients with NSTE ACS. METHODS: We evaluated patient characteristics and transfusion rates in the overall population (n = 85,111) and determined outcomes and factors associated with need for transfusion in a subpopulation of patients who did not undergo CABG (n = 74,271) from 478 U.S. hospitals between January 1, 2001, and March 31, 2004. RESULTS: A total of 14.9% of the overall and 10.3% of the non-CABG population underwent transfusion during their hospitalization. Renal insufficiency and advanced age were strongly associated with the likelihood of transfusion. Interhospital transfusion rates varied significantly. Non-CABG patients who received transfusions had a greater risk of death (11.5% vs. 3.8%) and death or reinfarction (13.4% vs. 5.8%) than patients who did not undergo transfusion. CONCLUSIONS: Transfusion is common in the setting of NSTE ACS, and patients who undergo transfusion are sicker at baseline and experience a higher risk of adverse outcomes than their nontransfused counterparts. Given the wide variation in transfusion practice, further efforts to understand patient and process factors that result in bleeding and need for transfusion in NSTE ACS are needed.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

October 18, 2005

Volume

46

Issue

8

Start / End Page

1490 / 1495

Location

United States

Related Subject Headings

  • Syndrome
  • Risk Factors
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Clinical Trials as Topic
  • Cardiovascular System & Hematology
  • Blood Transfusion
 

Citation

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Yang, X., Alexander, K. P., Chen, A. Y., Roe, M. T., Brindis, R. G., Rao, S. V., … CRUSADE Investigators, . (2005). The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. J Am Coll Cardiol, 46(8), 1490–1495. https://doi.org/10.1016/j.jacc.2005.06.072
Yang, Xin, Karen P. Alexander, Anita Y. Chen, Matthew T. Roe, Ralph G. Brindis, Sunil V. Rao, W Brian Gibler, E Magnus Ohman, Eric D. Peterson, and Eric D. CRUSADE Investigators. “The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative.J Am Coll Cardiol 46, no. 8 (October 18, 2005): 1490–95. https://doi.org/10.1016/j.jacc.2005.06.072.
Yang, Xin, et al. “The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative.J Am Coll Cardiol, vol. 46, no. 8, Oct. 2005, pp. 1490–95. Pubmed, doi:10.1016/j.jacc.2005.06.072.
Yang X, Alexander KP, Chen AY, Roe MT, Brindis RG, Rao SV, Gibler WB, Ohman EM, Peterson ED, CRUSADE Investigators. The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. J Am Coll Cardiol. 2005 Oct 18;46(8):1490–1495.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

October 18, 2005

Volume

46

Issue

8

Start / End Page

1490 / 1495

Location

United States

Related Subject Headings

  • Syndrome
  • Risk Factors
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Clinical Trials as Topic
  • Cardiovascular System & Hematology
  • Blood Transfusion