Publications by authors named "Caroline Alsweiler"
Background: Chronic kidney disease (CKD) is associated with higher risk of myocardial infarction and anemia. Among patients with anemia and CKD who experience myocardial infarction, it remains uncertain if a liberal red blood cell transfusion threshold strategy (hemoglobin cutoff [Hgb] < 10 g/dL) is superior to a restrictive transfusion threshold (Hgb 7-8 g/dL) strategy.
Methods: Among the 3,504 patients enrolled in the Myocardial Ischemia and Transfusion (MINT) trial with non-missing creatinine, we compared baseline characteristics and 30-day and 6-month outcomes of patients without CKD (N = 1279), CKD with eGFR 30-60 mL/min/1.
Background: The MINT trial (Myocardial Ischemia and Transfusion) raised concern for harm from a restrictive versus liberal transfusion strategy in patients with acute myocardial infarction (MI) and anemia. Type 1 and type 2 MI are distinct pathophysiologic entities that may respond differently to blood transfusion. This analysis sought to determine whether the effects of transfusion varied among patients with a type 1 or a type 2 MI and anemia.
View Article and Find Full Text PDFArticle Synopsis
- A study compared two blood transfusion strategies for patients with myocardial infarction and low hemoglobin: a restrictive strategy (transfusion if hemoglobin <7 or 8 g/dL) and a liberal strategy (transfusion if hemoglobin <10 g/dL).
- Involving 3,504 patients, results showed that the liberal group received significantly more transfusions but did not experience a reduced risk of death or recurrent myocardial infarction at 30 days compared to the restrictive group.
- The findings suggest that while the liberal strategy may not improve outcomes, the potential risks of the restrictive strategy remain uncertain, indicating the need for further research.
Background: Accumulating evidence from clinical trials suggests that a lower (restrictive) hemoglobin threshold (<8 g/dL) for red blood cell (RBC) transfusion, compared with a higher (liberal) threshold (≥10 g/dL) is safe. However, in anemic patients with acute myocardial infarction (MI), maintaining a higher hemoglobin level may increase oxygen delivery to vulnerable myocardium resulting in improved clinical outcomes. Conversely, RBC transfusion may result in increased blood viscosity, vascular inflammation, and reduction in available nitric oxide resulting in worse clinical outcomes.
View Article and Find Full Text PDF