There have been very few studies that have provided robust, generalized data concerning the prognostic impact of anemia in patients hospitalized with ischemic heart disease. More importantly, there is limited data concerning how to manage these patients and specifically whether transfusion is a beneficial in this population, and if so, at what hematocrit threshold?

“This research paper provides the largest, most robust demonstration of the risks associated with anemia in elderly patients hospitalized for a heart attack.”

Our study was able to address both of these issues by demonstrating that anemia was associated with increased mortality in elderly patients hospitalized with a myocardial infarction. Moreover, we found evidence that blood transfusions appeared to reduce mortality when used in such patients up to a hematocrit level of 33%. With little evidence previously available to guide the appropriate management of these patients, our study’s findings gave physicians some guidance on how to manage this patient population.

Our paper provides the largest national assessment of transfusion use and effectiveness in patients hospitalized with an acute myocardial infarction. This new discovery will help better direct the clinical management of literally thousands of elderly patients hospitalized for a myocardial infarction each year.

This research paper provides the largest, most robust demonstration of the risks associated with anemia in elderly patients hospitalized for a heart attack. In addition, it shows that providing blood transfusions to such patients may be beneficial up to hematocrit levels of 33%, but that transfusions above this threshold are unlikely to provide benefit and may even be harmful.

I have spent the past 15 years involved in research that tries to help clinicians provide higher quality cardiovascular care to their patients, particularly for groups that have been historically underrepresented in clinical research, such as women, the elderly, and minorities. This involves not only trying to decide what treatments or management strategies work best for common clinical problems, but also trying to find ways to ensure that knowledge is incorporated in daily clinical practice. I have used detailed clinical data to investigate the treatment of elderly patients hospitalized with ischemic heart disease for over a decade through my involvement with the Centers for Medicare & Medicaid Services. In the course of this work, I recognized the lack of high-quality evidence underlying guidelines directing the management of anemia in elderly patients with heart disease, and specifically the wide variation in transfusion practices. This is obviously an important question given our limited blood supply, the potential risks associated with unnecessary transfusions, and the possibility that some transfusions may be harmful in some patients given their hearts’ limited capabilities immediately after a heart attack. Our research group developed an analysis that was able to use the data collected as part of the Cooperative Cardiovascular Project, a quality-of-care initiative overseen by the Centers for Medicare & Medicaid Services, to address this question.