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Blood Transfusions Could Save Lives of Older Heart Attack Patients

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October 29, 2001|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

Elderly heart attack patients who are anemic should be given blood transfusions as soon as possible as part of their therapy, Yale University researchers said, adding that thousands of lives might be saved if such a recommendation were widely followed in the United States.

Physicians have not done this in the past, experts said, because there was little evidence to support its efficacy.

During a heart attack, heart muscle is starved for oxygen, and oxygen-poor blood resulting from anemia simply makes the situation worse, the researchers said.

Dr. Harlan Krumholz and his colleagues at Yale studied the records of 78,974 Medicare patients treated for heart attacks in 1994 and 1995.

They reported in the Oct. 25 New England Journal of Medicine that about three-quarters of the patients who were anemic did not receive transfusions.

Among those who did, however, the results were dramatic. Those who were mildly anemic and received transfusions were one-quarter less likely to die during the month after the heart attack than those who did not get blood. And those who were severely anemic and received transfusions were about two-thirds less likely to die during the same period.

Birth Control Pills May Weaken Sex Drive

Birth control pills might reduce women's libido by blunting their sense of smell, Italian researchers reported in the Oct. 26 issue of Human Reproduction, a scientific journal. Salvatore Caruso and his colleagues at the University of Catania studied 60 women who were not using birth control pills, measuring their ability to detect six distinctive odors--anise, musk-ketone, clove, pyridine, citral and ammonia--at different times of the month.

The women were most sensitive to the smells during the period around ovulation. But when the same women were then given birth control pills, that increased sensitivity was blocked and their sensitivity to odors was constant throughout the month.

Some research has suggested that, biologically, odors influence reproductive processes in humans.

Diabetics Warned Against Reusing Insulin Syringes

The American Diabetes Assn. has reiterated its recommendation that diabetics not reuse disposable syringes for injecting insulin. In a statement in the November issue of Diabetes Care, a medical journal, the association warned that new, thinner needles are more likely to bend when reused. If that happens, the bent needle can lacerate the skin or even break off in the tissue. Reusing needles may also lead to inconsistent insulin absorption.

The association also warned that people who inject insulin with an insulin pen should not leave the needle on the pen between injections. That can allow air to enter the system, leading to under delivery of insulin.

Estrogen Therapy May Be Risky for Stroke Victims

Estrogen replacement therapy does not help prevent strokes in women who have already had one and may, in fact, slightly increase the risk of a second stroke, according to a new study.

The study follows recent reports that hormone treatment also is not effective in preventing heart disease.

Based on those studies, the American Heart Assn. in July recommended against prescribing the hormone solely to prevent heart disease and strokes. Estrogen therapy is effective, however, at preventing bone loss and easing symptoms of menopause.

Dr. Catherine M. Viscoli and her colleagues at Yale University studied 991 women, with an average age of 71, who had suffered either full strokes or so-called mini-strokes.

The women were randomly assigned to receive either a standard dose of estrogen or a placebo. The team reported in the Oct. 25 New England Journal of Medicine that, after eight years, 99 of the women getting estrogen had suffered further strokes, compared with 93 of those receiving placebo.

EKG May Not Indicate Accurate Status of Patient

Just because a patient's electrocardiogram appears normal after a heart attack does not mean the patient is out of danger, according to a new study.

Doctors at Wayne State University in Detroit have found that patients with normal EKGs after a heart attack are about three times as likely to die as was previously thought, a finding that suggests the patients should be given much more aggressive treatment.

An abnormal EKG is one of the primary signs of a heart attack. Such patients are normally given intensive treatment, such as angioplasty, bypass surgery and blood-thinning drugs. But some patients have a seemingly normal EKG. Their heart attack is detected by the presence in blood of enzymes released by damaged heart tissue. Because their EKGs are normal, however, physicians have usually given these patients only minimal treatment.

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