Meta-analysis of blood transfusion in patients with acute coronary syndrome

The purpose of this meta-analysis was to determine international patterns of blood transfusion in patients with acute coronary syndrome. Previous studies showed geographic heterogeneity in some aspects of acute coronary syndrome care. Data for variability in the use of blood transfusion in acute coronary syndrome management are limited. Pooled data from 3 international randomized trials of patients with non–ST-segment elevation acute coronary syndrome (n = 23,906) were analyzed to determine the association between non-United States) 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.

Rao, Sunil V, et al. “International variation in the use of blood transfusion in patients with non-ST-segment elevation acute coronary syndromes.” The American journal of cardiology 101.1 (2008):25-29.

Our study found an association between being treated outside the US for non–ST-segment elevation acute coronary syndrome and a lower risk of blood transfusion. The decreased risk was also present in patients who underwent CABG outside the United States relative to patients who underwent CABG in the United States. Results were remarkably consistent after repeating the analysis using robust statistical methods. Given that rates of 30-day and 6-month clinical outcomes did not correspond to rates of transfusion, the geographic heterogeneity in transfusion practice suggested there was either underuse or overuse of transfusions in various regions.

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