Restrictive vs. Liberal Red Blood Cell Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: A Systematic Review and Meta-Analysis Article Swipe
Yeshen Zhang
,
Zhengrong Xu
,
Yuming Huang
,
Qirao Ye
,
Nianjin Xie
,
Lihuan Zeng
,
Xingji Lian
,
Yining Dai
,
Jiyan Chen
,
Pengcheng He
,
Ning Tan
,
Liu Y
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2021.736163
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2021.736163
Objective: Anemia is frequent in patients with acute myocardial infarction (AMI), and the optimal red blood cell transfusion strategy for AMI patients with anemia is still controversial. We aimed to compare the efficacy of restrictive and liberal red cell transfusion strategies in AMI patients with anemia. Methods: We systematically searched PubMed, EMBASE, Web of Science, Cochrane Library, and Clinicaltrials.gov , from their inception until March 2021. Studies designed to compare the efficacy between restrictive and liberal red blood cell transfusion strategies in patients with AMI were included. The primary outcome was all-cause mortality, including overall mortality, in-hospital or follow-up mortality. Risk ratios (RR) with 95% confidence intervals (CI) were presented and pooled by random-effects models. Results: The search yielded a total of 6,630 participants in six studies. A total of 2,008 patients received restrictive red blood cell transfusion while 4,622 patients were given liberal red blood cell transfusion. No difference was found in overall mortality and follow-up mortality between restrictive and liberal transfusion groups (RR = 1.07, 95% CI = 0.82–1.40, P = 0.62; RR = 0.89, 95% CI = 0.56–1.42, P = 0.62). However, restrictive transfusion tended to have a higher risk of in-hospital mortality compared with liberal transfusion (RR = 1.22, 95% CI = 1.00–1.50, P = 0.05). No secondary outcomes, including follow-up reinfarction, stroke, and acute heart failure, differed significantly between the two groups. In addition, subgroup analysis showed no differences in overall mortality between the two groups based on sample size and design. Conclusion: Restrictive and liberal red blood cell transfusion have a similar effect on overall mortality and follow-up mortality in AMI patients with anemia. However, restrictive transfusion tended to have a higher risk of in-hospital mortality compared with liberal transfusion. The findings suggest that transfusion strategy should be further evaluated in future studies.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.3389/fcvm.2021.736163
- OA Status
- gold
- Cited By
- 9
- References
- 33
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3211358183
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W3211358183Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fcvm.2021.736163Digital Object Identifier
- Title
-
Restrictive vs. Liberal Red Blood Cell Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: A Systematic Review and Meta-AnalysisWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-11-16Full publication date if available
- Authors
-
Yeshen Zhang, Zhengrong Xu, Yuming Huang, Qirao Ye, Nianjin Xie, Lihuan Zeng, Xingji Lian, Yining Dai, Jiyan Chen, Pengcheng He, Ning Tan, Liu YList of authors in order
- Landing page
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https://doi.org/10.3389/fcvm.2021.736163Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.3389/fcvm.2021.736163Direct OA link when available
- Concepts
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Medicine, Myocardial infarction, Anemia, Blood transfusion, Meta-analysis, Internal medicine, Relative risk, Confidence interval, Cochrane Library, Subgroup analysis, Stroke (engine), Pediatrics, Mechanical engineering, EngineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
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9Total citation count in OpenAlex
- Citations by year (recent)
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2025: 4, 2023: 2, 2022: 3Per-year citation counts (last 5 years)
- References (count)
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33Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.differed | 221 |
| abstract_inverted_index.efficacy | 32, 71 |
| abstract_inverted_index.failure, | 220 |
| abstract_inverted_index.findings | 287 |
| abstract_inverted_index.frequent | 3 |
| abstract_inverted_index.patients | 5, 21, 43, 82, 131, 140, 267 |
| abstract_inverted_index.received | 132 |
| abstract_inverted_index.searched | 49 |
| abstract_inverted_index.strategy | 18, 291 |
| abstract_inverted_index.studies. | 126, 298 |
| abstract_inverted_index.subgroup | 229 |
| abstract_inverted_index.addition, | 228 |
| abstract_inverted_index.all-cause | 91 |
| abstract_inverted_index.evaluated | 295 |
| abstract_inverted_index.follow-up | 98, 156, 214, 263 |
| abstract_inverted_index.inception | 62 |
| abstract_inverted_index.included. | 86 |
| abstract_inverted_index.including | 93, 213 |
| abstract_inverted_index.intervals | 106 |
| abstract_inverted_index.mortality | 154, 157, 195, 236, 261, 264, 281 |
| abstract_inverted_index.outcomes, | 212 |
| abstract_inverted_index.presented | 109 |
| abstract_inverted_index.secondary | 211 |
| abstract_inverted_index.Objective: | 0 |
| abstract_inverted_index.confidence | 105 |
| abstract_inverted_index.difference | 149 |
| abstract_inverted_index.infarction | 9 |
| abstract_inverted_index.mortality, | 92, 95 |
| abstract_inverted_index.mortality. | 99 |
| abstract_inverted_index.myocardial | 8 |
| abstract_inverted_index.strategies | 40, 80 |
| abstract_inverted_index.Conclusion: | 247 |
| abstract_inverted_index.Restrictive | 248 |
| abstract_inverted_index.differences | 233 |
| abstract_inverted_index.in-hospital | 96, 194, 280 |
| abstract_inverted_index.restrictive | 34, 73, 133, 159, 185, 271 |
| abstract_inverted_index.transfusion | 17, 39, 79, 137, 162, 186, 199, 254, 272, 290 |
| abstract_inverted_index.0.56–1.42, | 180 |
| abstract_inverted_index.0.82–1.40, | 170 |
| abstract_inverted_index.1.00–1.50, | 206 |
| abstract_inverted_index.participants | 123 |
| abstract_inverted_index.transfusion. | 147, 285 |
| abstract_inverted_index.reinfarction, | 215 |
| abstract_inverted_index.significantly | 222 |
| abstract_inverted_index.controversial. | 26 |
| abstract_inverted_index.random-effects | 113 |
| abstract_inverted_index.systematically | 48 |
| abstract_inverted_index.Clinicaltrials.gov | 58 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 94 |
| corresponding_author_ids | https://openalex.org/A5100687679, https://openalex.org/A5100741013 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 12 |
| corresponding_institution_ids | https://openalex.org/I4210094836, https://openalex.org/I4210145693, https://openalex.org/I4210153930 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8700000047683716 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.5393931 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |