Red Cell Transfusion in Acute Myocardial Infarction: AABB International Clinical Practice Guidelines

作者：Monica B. Pagano, Simon Stanworth, Jane A Dennis, Sara Bakhtary, Jeannie Callum, Jeffrey L. Carson, Claudia S. Cohn, Allan Dubon, Brenda J. Grossman, Gaurav K. Gupta, Aaron S. Hess, Jessica L. Jacobson, Lewis J. Kaplan, Keyvan Karkouti, Yulia Lin, Ryan A. Metcalf, Lachlan F. Miles, Nicholas L. Mills, Colin Murphy, Katerina Pavenski, Micah T. Prochaska, Jay S. Raval, Eric Salazar, Nabiha H. Saifee, Kevin Shah, Philippe Gabríel Steg, Aaron A.R. Tobian, Cynthia So‐Osman, Timothy Walsh, Jonathan H. Waters, Erica M. Wood, Nicole D. Zantek, Gordon H. Guyatt · 发表于：Annals of Internal Medicine · 年份：2025 · DOI：10.7326/annals-25-00706 · 被引用次数：13 · 研究领域：Blood transfusion and management、Erythropoietin and Anemia Treatment、Hyperglycemia and glycemic control in critically ill and hospitalized patients

DESCRIPTION: Optimal transfusion strategies for patients with acute myocardial infarction (AMI) are uncertain. The aim of this guideline is to provide recommendations for red blood cell transfusion in patients with AMI. METHODS: These guidelines are based on evidence from randomized controlled trials of patients presenting with AMI and assigned to 2 different transfusion strategies (restrictive or liberal) based on hemoglobin concentrations or hematocrit levels before receipt of a transfusion. A meta-analysis of eligible trials was performed using Cochrane methods. The international panel followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methods to summarize evidence and formulate recommendations. This guideline's primary perspective is that of the patient, including medical, financial, and psychological effects, with secondary consideration of health care system issues, particularly conservation of the limited and costly blood supply. RECOMMENDATION: For hospitalized patients with AMI, the panel suggests a liberal red cell transfusion strategy when the hemoglobin concentration is less than 10 g/dL (conditional recommendation, low-certainty evidence). A restrictive strategy of 7 to 8 g/dL may result in increased mortality in patients with AMI. The direction of the recommendation for the liberal strategy was based on the great importance of mortality for patients. The conditional recommendation was based on the low certainty of evidence and the...