Abstract: Objective To evaluate the effect of restrictive blood transfusion versus liberal blood transfusion strategy in patients with Acute Myocardial Infarction using meta-analysis. Methods American Medical Library (PubMed), Holland Medical Abstract (Embase), Web of Science, SinMed, Weipu database, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from their start year up to Dec. 2022 for relevant randomized clinical trials (RCT) that compared restrictive blood transfusion to liberal blood transfusion in patients with Acute Myocardial Infarction. RCTs that met the inclusion criteria were screened and included, and meta-analysis was conducted using the RevMan5.3 software. The outcomes of in-hospital mortality, overall mortality, follow-up reinfarction, major adverse cardiovascular events (MACE) were evaluated. Results Six studies involving 3311 patients were included in this meta-analysis. The results of meta-analysis showed no significant difference between the two groups regarding the In-hospital mortality(RR(risk ratio)=0.68,95%CI：0.31~1.48,P=0.33),Overall mortality(RR=0.83,95%CI：0.47~1.49,P=0.54),Follow-up reinfarction(RR=1.59,95%CI：0.38~6.75,P=0.53),Unplanned revascularization(RR=0.83,95%CI：0.39~1.73,P=0.61),Heart Failure,(RR=0.74,95%CI：0.16~3.46,P=0.70)and Stroke(RR=0.69,95%CI：0.14~3.48,P=0.65). Conclusions No significant differences were seen in the In-hospital mortality,overall mortality,and the incidence of adverse cardiovascular events such as follow-up reinfarction,unplanned revascularization,heart failure and stroke occurrence in elderly patients with AMI when open transfusion was compared with restrictive transfusion.

Key words: Blood transfusion, Acute Myocardial infarction, Mortality, Meta-analysis