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International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.

Publication ,  Journal Article
Rao, SV; Chiswell, K; Sun, J-L; Granger, CB; Newby, LK; Van de Werf, F; White, HD; Armstong, PW; Califf, RM; Harrington, RA
Published in: Am J Cardiol
January 1, 2008

The purpose of this study was to determine international patterns of blood transfusion in patients with acute coronary syndrome (ACS). Previous studies showed geographic heterogeneity in some aspects of ACS care. Data for variability in the use of blood transfusion in ACS management are limited. Pooled data from 3 international randomized trials of patients with non-ST-segment elevation ACS (n = 23,906) were analyzed to determine the association between non-United States (US) location and blood transfusion after stratifying by the use of invasive procedures. The analysis adjusted for differences in patient characteristics and was repeated using a 2-stage mixed-model approach and in patients who underwent in-hospital coronary artery bypass grafting. Compared with US patients, both unadjusted and adjusted hazards for blood transfusion were significantly lower in non-US patients who did not undergo invasive procedures (unadjusted hazard ratio [HR] 0.23, 95% confidence interval [CI] 0.17 to 0.33; adjusted HR 0.20, 95% CI 0.14 to 0.28). This was also true in non-US patients who underwent invasive procedures (unadjusted HR 0.34, 95% CI 0.27 to 0.44; adjusted HR 0.31, 95% CI 0.23 to 0.42). Results were similar in both validation analyses. In conclusion, there was substantial international variation in blood transfusion use in patients with ACS. These results, along with the controversy regarding the appropriate use of transfusion in patients with coronary heart disease, emphasize the need for understanding the role of blood transfusion in the management of patients with ACS and factors that influence transfusion decisions.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 1, 2008

Volume

101

Issue

1

Start / End Page

25 / 29

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Internationality
  • Humans
  • Female
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
 

Citation

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Rao, S. V., Chiswell, K., Sun, J.-L., Granger, C. B., Newby, L. K., Van de Werf, F., … Harrington, R. A. (2008). International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol, 101(1), 25–29. https://doi.org/10.1016/j.amjcard.2007.07.042
Rao, Sunil V., Karen Chiswell, Jie-Lena Sun, Christopher B. Granger, L Kristin Newby, Frans Van de Werf, Harvey D. White, Paul W. Armstong, Robert M. Califf, and Robert A. Harrington. “International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.Am J Cardiol 101, no. 1 (January 1, 2008): 25–29. https://doi.org/10.1016/j.amjcard.2007.07.042.
Rao SV, Chiswell K, Sun J-L, Granger CB, Newby LK, Van de Werf F, et al. International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol. 2008 Jan 1;101(1):25–9.
Rao, Sunil V., et al. “International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.Am J Cardiol, vol. 101, no. 1, Jan. 2008, pp. 25–29. Pubmed, doi:10.1016/j.amjcard.2007.07.042.
Rao SV, Chiswell K, Sun J-L, Granger CB, Newby LK, Van de Werf F, White HD, Armstong PW, Califf RM, Harrington RA. International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes. Am J Cardiol. 2008 Jan 1;101(1):25–29.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

January 1, 2008

Volume

101

Issue

1

Start / End Page

25 / 29

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Internationality
  • Humans
  • Female
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Cardiac Catheterization