Hemodynamics, fluids & transfusion
Liberal versus restrictive transfusion strategies in acute myocardial infarction: a systematic review and comparative frequentist and Bayesian meta-analysis of randomized controlled trials
Authors' conclusion
Our analysis did not demonstrate a significant benefit in early mortality with a liberal transfusion strategy compared to a restrictive strategy for AMI, low certainty of evidence. Liberal transfusion may reduce the risk of the composite outcome death or MI, with very low certainty of evidence.
Study context
- Population
- Patients with acute myocardial infarction (MI) (AMI)
- Participants
- 4,324 patients · 4 randomized controlled trials (RCTs)
- Comparison
- Liberal vs restrictive transfusion strategy
- Outcome
- Latest measured mortality within 90 days following MI
- Follow-up
- Within 90 days
Methodological detailsfrequentist and Bayesian meta-analysis, fixed-effect and random-effects models, sensitivity analysis (low risk of bias studies only; Bayesian)
- Frequentist and Bayesian meta-analysis
- Fixed-effect and random-effects models
- Sensitivity analysis (low risk of bias studies only; Bayesian)
Pooled result
As reported in the abstract
Latest measured mortality within 90 days after MI
Mortality, fixed-effect model: RR (95% CI 0.95-1.40), no significant reduction
1.16
Mortality, random-effects model: RR (95% CI 0.67-1.91), no significant reduction
1.13
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Composite of death or MIFixed-effect and random-effects models; I2 = 0%, p = 0.46 · GRADE: very low certainty of evidence · primarily driven by a single study | 1.18 (1.01–1.37) | |
| 0.512Relative risk (log scale) |
Cardiac mortality
- Fixed-effects model: significant RR
- 1.42 (95% CI 1.07-1.88)
- Random-effects model: non-significant RR
- 1.05 (95% CI 0.36-3.80)
Other secondary endpoints (recurrent MI, stroke, unplanned revascularization)
- No statistically significant results
Original publication
Liberal versus restrictive transfusion strategies in acute myocardial infarction: a systematic review and comparative frequentist and Bayesian meta-analysis of randomized controlled trials. Ann Intensive Care. Published 28 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →