Abstract
Background
Anemia is common in older individuals, but it is not known whether the prognostic
impact of transfusion differs according to cardiac troponin concentration.
Methods
During this 2-year retrospective study in an acute geriatric unit, 514 patients with
hemoglobin <10 g/dL and troponin sampling were included. Thirty-day and 1-year mortality
were compared according to transfusion status and troponin and hemoglobin levels.
Results
Of the 514 anemic patients included (median age 88 years), 157 (31%) had elevated
troponin concentrations. These patients were more likely to die at 30 days (49% vs
27%, P < .001) and 1 year (65% vs 51%, P = .004) than patients with normal values. Among patients with elevated troponin concentrations,
30-day mortality tended to be lower in transfused than in not-transfused patients
(hazard ratio 0.48; 95% confidence interval, 0.21-1.08; P = .07). This association was not found in patients without troponin elevation (hazard
ratio 1.09; 95% CI, 0.61-1.93; P = .8). Transfusion was associated with 30-day survival in patients with hemoglobin
≤8 g/dL. It was also associated with excess 1-year mortality in patients with hemoglobin
>8 g/dL.
Conclusions
This pilot study suggests that transfusion could be associated with better 30-day
outcomes in older anemic patients with anemia-related myocardial injury. Thus, troponin
levels could be involved in decision-making relative to transfusion in anemic older
patients. Clinical trials are needed to establish the benefit of transfusion in patients
with elevated troponins.
Keywords
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Article Info
Publication History
Published online: April 22, 2022
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and had a role in writing the manuscript.
Identification
Copyright
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