Higuchi Satoshi, Hata Noritaka, Shibata Shigeki, Hirabuki Kazukuni, Suda Tomoya, Honda Kazuna, Hasegawa Hiroshi, Matsuda Takeaki
Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Department of Emergency and General Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Int J Cardiol. 2021 Feb 1;324:102-107. doi: 10.1016/j.ijcard.2020.09.028. Epub 2020 Sep 15.
Anemia has been recognized as an important comorbidity in patients with acute heart failure (AHF) and is associated with adverse clinical events. However, the clinical impact of red blood cell (RBC) transfusion in such patients is unclear.
This study was a retrospective single-center registry including AHF patients admitted to Kyorin University Hospital between 2007 and 2014. Anemia was defined as a hemoglobin level < 130 g/L in males or < 120 g/L in females. Those with major bleeding with a fall in hemoglobin concentration of >20 g/L were excluded. AHF readmission at 3 months and in-hospital and 2-year all-cause mortality were evaluated.
Of 501 AHF patients, 38 were excluded owing to major bleeding; finally, 463 (age, 77 ± 11 years; males, 58%) were evaluated. RBC transfusion during hospitalization was performed in 112 patients (24%). Hemoglobin level on admission was 105 ± 16 g/L (transfusion, 89 ± 17 g/L; no transfusion, 110 ± 12 g/L; p < 0.001). AHF readmission at 3 months and in-hospital and 2-year all-cause mortality were observed in 46 (10%), 16 (3%), and 121 (26%) patients, respectively. Univariate Cox regression analysis demonstrated that RBC transfusion was not associated with AHF readmission at 3 months (hazard ratio: 0.80; 95% confidence interval: 0.39-1.66) The association did not differ at any hemoglobin concentration or left ventricular ejection fraction value. Multivariate Cox regression analysis revealed similar results. Furthermore, RBC transfusion was not correlated with in-hospital and 2-year all-cause mortality.
RBC transfusion was not associated with AHF readmission or all-cause mortality.
贫血已被认为是急性心力衰竭（AHF）患者的一种重要合并症，且与不良临床事件相关。然而，红细胞（RBC）输注在此类患者中的临床影响尚不清楚。
本研究为一项回顾性单中心登记研究，纳入了2007年至2014年期间入住杏林大学医院的AHF患者。贫血定义为男性血红蛋白水平<130g/L或女性血红蛋白水平<120g/L。排除血红蛋白浓度下降>20g/L的大出血患者。评估3个月时的AHF再入院情况以及住院期间和2年的全因死亡率。
501例AHF患者中，38例因大出血被排除；最终，对463例患者（年龄77±11岁；男性占58%）进行了评估。112例患者（24%）在住院期间接受了RBC输注。入院时血红蛋白水平为105±16g/L（输血患者为89±17g/L，未输血患者为110±12g/L；p<0.001）。分别有46例（10%）、16例（3%）和121例（26%）患者出现3个月时的AHF再入院、住院期间死亡和2年全因死亡。单因素Cox回归分析表明，RBC输注与3个月时的AHF再入院无关（风险比：0.80；95%置信区间：0.39-1.66）。在任何血红蛋白浓度或左心室射血分数值时，这种关联均无差异。多因素Cox回归分析得出了相似的结果。此外，RBC输注与住院期间和2年全因死亡率均无相关性。
RBC输注与AHF再入院或全因死亡率无关。
