Abstract：
BACKGROUND: Blood transfusion strategies in patients with acute myocardial infarction (AMI) and anemia are yet to be conclusively identified. Thus, we aim to assess the efficacy and safety of restrictive versus liberal blood transfusion strategies for AMI and anemia.
METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, web of science, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials were performed through November 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). (PROSPERO): ID: CRD42023490692.
RESULTS: We included four RCTs with 4.325 patients. There was no significant difference between both groups regarding MACE whether at 30 days (RR: 0.93 with 95% CI [0.57-1.51], P = 0.76) or ≥ six months (RR: 1.17 with 95% CI [0.95-1.45], P = 0.14), all-cause mortality at 30 days (RR: 1.16 with 95% CI [0.95-1.40], P = 0.14) or ≥ six months (RR: 1.16 with 95% CI [0.88-1.53], P = 0.28). However, the liberal strategy was significantly associated with increased hemoglobin level change (MD: -1.44 with 95% CI [-1.68 to -1.20], P < 0.00001). However, the restrictive strategy was significantly associated with a lower incidence of acute lung injury (RR: 0.11 with 95% CI [0.02-0.60], P = 0.01).
CONCLUSIONS: There was no significant difference between the restrictive blood transfusion strategy and the liberal blood transfusion strategy regarding the clinical outcomes. However, restrictive blood transfusion strategy was significantly associated with a lower incidence of acute lung injury than liberal blood transfusion strategy.
METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, web of science, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials were performed through November 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). (PROSPERO): ID: CRD42023490692.
RESULTS: We included four RCTs with 4.325 patients. There was no significant difference between both groups regarding MACE whether at 30 days (RR: 0.93 with 95% CI [0.57-1.51], P = 0.76) or ≥ six months (RR: 1.17 with 95% CI [0.95-1.45], P = 0.14), all-cause mortality at 30 days (RR: 1.16 with 95% CI [0.95-1.40], P = 0.14) or ≥ six months (RR: 1.16 with 95% CI [0.88-1.53], P = 0.28). However, the liberal strategy was significantly associated with increased hemoglobin level change (MD: -1.44 with 95% CI [-1.68 to -1.20], P < 0.00001). However, the restrictive strategy was significantly associated with a lower incidence of acute lung injury (RR: 0.11 with 95% CI [0.02-0.60], P = 0.01).
CONCLUSIONS: There was no significant difference between the restrictive blood transfusion strategy and the liberal blood transfusion strategy regarding the clinical outcomes. However, restrictive blood transfusion strategy was significantly associated with a lower incidence of acute lung injury than liberal blood transfusion strategy.
摘要：
背景：急性心肌梗死（AMI）和贫血患者的输血策略尚未最终确定。因此，我们的目的是评估限制性输血与自由输血治疗AMI和贫血的疗效和安全性.
方法：从PubMed检索的随机对照试验（RCT）的系统评价和荟萃分析，科学网,Scopus,EMBASE,和Cochrane中央对照试验登记册进行到2023年11月。我们使用RevManV.5.4汇总使用风险比（RR）的二分数据和使用平均差（MD）的连续数据，置信区间为95％（CI）。(PROSPERO):ID:CRD42023490692。
结果：我们纳入了4.325例患者的4个RCT。两组在30天的MACE方面均无显著差异(RR:0.93,95%CI[0.57-1.51],P=0.76)或≥6个月(RR：1.17，95%CI[0.95-1.45]，P=0.14),30天全因死亡率(RR：1.16，95%CI[0.95-1.40]，P=0.14)或≥6个月(RR：1.16，95%CI[0.88-1.53]，P=0.28）。然而,自由主义策略与血红蛋白水平变化显著相关(MD:-1.44,95%CI[-1.68至-1.20],P<0.00001)。然而,限制性策略与较低的急性肺损伤发生率显着相关（RR：0.11，95％CI[0.02-0.60]，P=0.01）。
结论：限制性输血策略和自由输血策略在临床结局方面没有显著差异。然而,与自由输血策略相比,限制性输血策略与急性肺损伤发生率较低显著相关.
方法：从PubMed检索的随机对照试验（RCT）的系统评价和荟萃分析，科学网,Scopus,EMBASE,和Cochrane中央对照试验登记册进行到2023年11月。我们使用RevManV.5.4汇总使用风险比（RR）的二分数据和使用平均差（MD）的连续数据，置信区间为95％（CI）。(PROSPERO):ID:CRD42023490692。
结果：我们纳入了4.325例患者的4个RCT。两组在30天的MACE方面均无显著差异(RR:0.93,95%CI[0.57-1.51],P=0.76)或≥6个月(RR：1.17，95%CI[0.95-1.45]，P=0.14),30天全因死亡率(RR：1.16，95%CI[0.95-1.40]，P=0.14)或≥6个月(RR：1.16，95%CI[0.88-1.53]，P=0.28）。然而,自由主义策略与血红蛋白水平变化显著相关(MD:-1.44,95%CI[-1.68至-1.20],P<0.00001)。然而,限制性策略与较低的急性肺损伤发生率显着相关（RR：0.11，95％CI[0.02-0.60]，P=0.01）。
结论：限制性输血策略和自由输血策略在临床结局方面没有显著差异。然而,与自由输血策略相比,限制性输血策略与急性肺损伤发生率较低显著相关.
