• Manon Thevenin, Sophie Putot, Patrick Manckoundia, and Alain Putot.
• Acute Geriatric Unit, Dijon University Hospital, Dijon, France.
• Am. J. Med. 2022 Aug 1; 135 (8): 10081015.e11008-1015.e1.

BackgroundAnemia is common in older individuals, but it is not known whether the prognostic impact of transfusion differs according to cardiac troponin concentration.MethodsDuring this 2-year retrospective study in an acute geriatric unit, 514 patients with hemoglobin <10 g/dL and troponin sampling were included. Thirty-day and 1-year mortality were compared according to transfusion status and troponin and hemoglobin levels.ResultsOf the 514 anemic patients included (median age 88 years), 157 (31%) had elevated troponin concentrations. These patients were more likely to die at 30 days (49% vs 27%, P < .001) and 1 year (65% vs 51%, P = .004) than patients with normal values. Among patients with elevated troponin concentrations, 30-day mortality tended to be lower in transfused than in not-transfused patients (hazard ratio 0.48; 95% confidence interval, 0.21-1.08; P = .07). This association was not found in patients without troponin elevation (hazard ratio 1.09; 95% CI, 0.61-1.93; P = .8). Transfusion was associated with 30-day survival in patients with hemoglobin ≤8 g/dL. It was also associated with excess 1-year mortality in patients with hemoglobin >8 g/dL.ConclusionsThis pilot study suggests that transfusion could be associated with better 30-day outcomes in older anemic patients with anemia-related myocardial injury. Thus, troponin levels could be involved in decision-making relative to transfusion in anemic older patients. Clinical trials are needed to establish the benefit of transfusion in patients with elevated troponins.Copyright © 2022 Elsevier Inc. All rights reserved.

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