Transfusion Trigger Trial in Coronary Artery Disease: A Pilot Study

Project Details

Description

DESCRIPTION (provided by applicant): Red blood cell transfusions are extremely common medical interventions with more than 11 million red blood cell units transfused in the United States and 75 million worldwide. Yet, it remains unclear when patients should receive red blood cell transfusions in most clinical settings. Coronary artery disease (CAD) is a common life threatening illness. Patients with acute coronary syndrome and coronary artery disease frequently become anemic because they undergo invasive procedures and are treated with multiple classes of anticoagulants. Oxygen delivery to the myocardium is flow dependent and myocardial ischemia may be precipitated by low hemoglobin concentrations. Therefore, many physicians believe that patients with underlying cardiovascular disease should be transfused to maintain hemoglobin above 10 g/dL. However, there has never been a randomized clinical trial evaluating transfusion triggers in anemic patients with active CAD. This application proposes performance of a pilot study that will be used to plan a large multicenter pragmatic trial evaluating transfusion thresholds in patients with coronary artery disease. We will perform a randomized clinical trial in 200 patients age 18 or older admitted to the hospital with 1) STEMI (ST segment elevated myocardial infarction), 2) NSTEMI (Non ST segment elevation myocardial infarction), 3) unstable angina, or 4) stable coronary artery disease patient who undergoing cardiac catherization during the index hospitalization with at least 70% obstruction by visual inspection. The patient must have a hemoglobin concentration less than 10 g/dL at the time of random allocation to liberal (10 g/dL threshold) transfusion strategy or restrictive (
StatusFinished
Effective start/end date9/30/098/31/12

Funding

  • National Institutes of Health: $1,213,014.00
  • National Institutes of Health: $1,392,130.00

ASJC

  • Medicine(all)

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