Transfusion Cutoff for Patients with Acute Myocardial Infarction and Anemia


In a large trial, differences in key outcomes favoring a liberal transfusion strategy just missed statistical significance.

A restrictive transfusion strategy (hemoglobin [Hb] cutoff, <7 g/dL) is accepted widely as the standard of care for most hospitalized patients. However, some controversy remains for patients with acute myocardial infarction (MI) and anemia (NEJM JW Gen Med May 1 2021 and JAMA 2021; 325:552). In this international study, researchers randomized 3500 adult patients with MI and anemia (Hb level, ≤10 g/dL) to either a restrictive transfusion strategy (Hb cutoff, <7 or <8 g/dL, per clinician judgment) or a liberal transfusion strategy (Hb cutoff, <10 g/dL).

At 30 days after randomization, the incidence of key outcomes for patients in the restrictive- and liberal-transfusion groups, respectively, were as follows:

  • Primary outcome (recurrent MI or death at 30 days): 16.9% vs. 14.5%
  • Death: 9.9% vs. 8.3%
  • Recurrent MI: 8.5% vs. 7.2%

For each of the above endpoints, the numerical difference that suggested better outcomes with liberal transfusion just missed statistical significance. As expected, the total number of transfused units was much higher in the liberal-strategy group (4300 vs 1200 units), and patients in the liberal-strategy group were almost three times more likely to receive at least 1 transfused unit (95% vs. 34%). However, the incidence of new or worsening heart failure was only slightly (and not significantly) higher with the liberal strategy (6.3% vs. 5.8%).

Comment

This is the largest study to date of transfusion cutoffs among patients with acute MI and anemia. The borderline statistical differences in major adverse outcomes, slightly favoring the liberal strategy, suggest that clinicians should have some latitude in picking a transfusion threshold (i.e., somewhere between 7 and 10 g/dL). Nevertheless, a tendency toward a restrictive strategy also remains reasonable, given the lower consumption of blood resources, fewer transfusion reactions, and cost savings.

Make Giving a Habit! Why Blood Donation Matters.


A glimpse into the importance of blood donation and busting myths about the process, on World Blood Dono

JNone of us are strangers to blood donation. “Blood needed urgently….” texts on our messaging groups, donation camps at college, societies and offices, or donating blood after recovering from a COVID-19 infection; are all scenarios we’ve encountered at some point in our lives and will continue to do so. Especially, with the COVID-19 pandemic reiterating the importance of community— of helping each other in times of need. A health emergency calls for a spirit of solidarity. However, it should not take a crisis for us to come together and support one another.

Here’s why – there is an alarming shortage of blood, worldwide. In India, during 2020-21, around 1.03 crore blood units were collected at 3500 licensed Blood Centers, meeting 71% of the estimated clinical demand in the country. Due to the Covid-19 impact in the country, the total blood units collected in 2020-21 has decreased as compared to blood units collected in 2019-20 i.e. 1.25 crore units. With only about 30-35% participation from people aged 18-28 and female donors comprising only less than 10% donors, targeted awareness and donation efforts have become crucial.

The importance of blood donation & why giving matters.

As an essential life force, blood is composed of white and red blood cells and platelets based in a liquid called plasma, whole blood and its components are invaluable for our health. This is even more so in medical procedures, when it comes to aiding the health of others in need.

Whether used in emergency surgeries, medical therapies or even routine procedures, the importance of blood donation cannot be overstated. From helping those with health challenges like cancer to accident victims, children with severe anemia, organ transplant patients, those battling organ failure, infections, newborns and more… regular blood donations can save and enrich lives across ages, stages and geographies. The ability to help and make a difference is quite literally in our veins. 

hiv-testing-to-keep-us-on-track

HIV Testing to Keep us on Track

Why widespread blood donation awareness is key.

Blood is inherently regenerative – our bodies can physiologically replenish blood components continuously within few weeks after blood donation. So we needn’t wait for an emergency to donate it. A healthy body can regularly donate blood that can be stored and used when needed.

As per estimations from WHO, voluntary blood donation from 1% of a nation’s population is generally required to meet its most basic requirements for blood. Blood can only be stored for a limited period of time; therefore, regular donations are essential to keep up with the demand and ensure that there is enough for all those who may need a blood transfusion. However, misconceptions result in a much lower number of donors, making it imperative to raise awareness around the issue.

Sifting through some common blood donation facts and myths

Myth: Donations are only accepted from young adults.

Fact: Healthy, older adults too can safely donate blood! Anyone from the ages of 18 to 65 are considered viable blood donors, subject to health conditions and regulations.

Myth: Donating blood can make you sick

Fact: Donating blood does not impact your health or put your health in danger. In fact, a check-up, including tests for health markers like blood pressure, temperature, pulse and hemoglobin level amongst others prior to making a donation is usually the norm and can put your mind at ease. Some people may experience minor temporary effects such as redness at the insertion site, slight dizziness or nausea which usually resolves itself soon with rest and food.

Myth: Donating blood is very painful

Fact: Apart from slight discomfort during the insertion of the needle, blood donation is a fairly pain-free and comfortable process later on.

Myth: You can only give blood annually.

Fact: While conditions may differ as per your individual health level and needs, blood can usually be  safely donated every 3 months for men and every 4 months for women. This gap allows the body to return to its normal hemoglobin levels.

Further, making ‘giving back’ a habit and contributing to larger community wellbeing not only transforms the lives of others, but can also benefit your own health— for example, studies show that donating blood regularly is associated with a reduction in hypertension. 

Creating Healthier Futures… For People & The Planet.

BE THE 1 to make a difference!

At Abbott, we recognize how small, consistent steps can make a big, life-changing difference to innumerable others around us. Abbott screens more than 60% of the world’s blood supply.  We work together with partner blood banks to support blood donation efforts by spreading awareness about the critical need for donation as well as creating smoother services to help facilitate the process.

Our BE THE 1 campaign in India highlights the cultural importance of donation for the younger generation, and the need to get more women involved in matters of their health and become proactive donors. From convenient and hygienic mobile blood donation facilities to inspiring engagement activities –  continued efforts to make blood donation relevant and empowering has helped bridge the gap and raise donation levels in targeted areas by over 15%! Raising awareness about safe blood donation and transfusion services also acts as a strong driving force for timely, safe and sustainable blood supply.

Let World Blood Donor Day (celebrated on June 14), remind us of the importance of blood donation awareness and the far-reaching impact individuals can have in offering hope and health to communities. It’s a habit worth building.

World Blood Donor Day 2022: Donating blood is an act of solidarity. Join the effort and save lives


https://www.who.int/news-room/events/detail/2022/06/14/default-calendar/world-blood-donor-day-2022