Ducrocq, GregoryCachanado, MarineSimon, TabassomePuymirat, EtienneLemesle, GillesLattuca, BenoitAriza Solé, AlbertSilvain, JohanneFerrari, EmileGonzalez Juanatey, Jose R.Martínez Sellés, ManuelLermusier, ThibaultCoste, PierreVanzetto, GeraldCottin, YvesDillinger, Jean G.Calvo Rojas, GonzaloSteg, Philippe GabrielREALITY Investigators2024-11-192024-11-192024-09-011916-7075https://hdl.handle.net/2445/216595Background: Red blood cell transfusion can cause fluid overload. We evaluated the interaction between heart failure (HF) at baseline and transfusion strategy on outcomes in acute myocardial infarction (AMI). Methods: We used data from the randomized REALITY trial. HF was defined as history of HF or Killip class > 1 at randomization. Primary outcome was major adverse cardiovascular events (MACE): composite of all-cause death, nonrecurrent AMI, stroke, or emergency revascularization prompted by ischemia at 30 days. Results: Among 658 randomized patients, 311 (47.3%) had HF. Patients with HF had higher rates of MACE at 30 days and 1 year and higher rates of nonfatal new-onset HF. There was no interaction between HF and effect of randomized assignment on the primary outcome or nonfatal new-onset HF. A liberal transfusion strategy was associated with increased all-cause death at 30 days and at 1 year in patients with HF (P-interaction = 0.009 and P = 0.049, respectively). The main numerical difference in cause of death between restrictive and liberal strategies was death by HF at 30 days (4 vs 11). Conclusions: HF is frequent in patients with AMI and anemia and is associated with higher risk of MACE (including all-cause death) and nonfatal new-onset HF. Although there was no interaction of HF with effect of transfusion strategy on MACE, a liberal transfusion strategy was associated with higher all-cause death that appears driven by a higher risk of early death caused by HF.10 p.application/pdfengcc-by (c) Ducrocq, Gregory et al., 2024http://creativecommons.org/licenses/by/3.0/es/Infart de miocardiAnèmiaTransfusió de sangInsuficiència cardíacaMyocardial infarctionAnemiaBlood transfusionHeart failureinfo:eu-repo/semantics/article2024-10-04info:eu-repo/semantics/openAccess38408702