CardiovascularImpact of transfusion on stroke after cardiovascular interventions: Meta-analysis of comparative studies

PurposeTo evaluate the impact of transfusion on the development of stroke after cardiovascular interventions.MethodsA literature search was performed to identify comparative studies on the impact of blood transfusion on the occurrence of stroke after adult cardiac surgery and interventional cardiology procedures.ResultsTwenty-four studies compared the outcome of 80 283 patients who received and 2 260 709 patients who did not receive blood transfusion after cardiovascular interventions. Pooled analysis showed that transfused patients had a higher risk of postoperative stroke (2.1% vs 0.9%; P < .001; risk ratio [RR], 2.563; 95% confidence interval [CI], 1.615-4.069; I2 = 94%) compared with patient who did not receive blood transfusion. The leave-one-out analysis confirmed the consistency of the overall series (RR ranged from 2.367 [95% CI, 1.978-2.834] to 2.676 [95% CI, 1.679-4.265]). Transfusion was associated with increased risk of stroke after either interventional cardiology interventions (3.2% vs 1.1%; RR, 3.325; 95% CI, 1.579-7.004) or cardiac surgery (1.9% vs 0.8%; RR, 2.260; 95% CI, 1.845-2.769). Generic inverse variance analysis of 11 studies reporting adjusted odds ratios for baseline characteristics showed that transfusion after cardiovascular interventions was an independent predictor of stroke (RR, 1.53; 95% CI, 1.10-2.14; I2 = 0%).ConclusionBlood transfusion is associated with a significantly increased risk of postoperative stroke in patients undergoing cardiovascular interventions.RegistrationThe present meta-analysis is registered in PROSPERO, code CRD42016046426.