{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:55:50Z","timestamp":1771473350048,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Portuguese Foundation for Science and Technology"},{"name":"Cardiovascular R&D Center\u2014UnIC","award":["UIDB\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020"]}]},{"name":"Cardiovascular R&D Center\u2014UnIC","award":["UIDP\/00051\/2020"],"award-info":[{"award-number":["UIDP\/00051\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To compare the independent and combined effects of anaemia and red blood cell transfusion on late survival after isolated coronary artery bypass grafting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Retrospective analysis of 5243 consecutive patients undergoing primary isolated coronary artery bypass grafting, performed from 2000 to 2015, in a Portuguese Academic Hospital. We identified 1649 patients with preoperative anaemia (A+) and 1422 patients who received a perioperative transfusion (T+)\u2014the 4 possible combinations allowed for the creation of 4 subgroups (A\u2212\/T\u2212, A\u2212\/T+, A+\/T\u2212 and A+\/T+). The primary endpoint was all-cause mortality at 10 years. We employed inverse probability weighting to control for confounding variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Thirty-one percent of the patients had preoperative anaemia, and 27.0% had at least one packed red blood cell transfusion. Inverse probability weighting was effective in eliminating differences in all significant baseline characteristics. The primary endpoint of all-cause mortality at 10 years occurred in 568 patients (20.5%) in the A\u2212\/T\u2212 group, as compared with 204 (24.4%) in the A\u2212\/T+ group (hazard ratio, 1.14; 95% confidence interval, 1.00 to 1.31; P\u2009=\u20090.053), 358 (33.8%) in the A+\/T\u2212 group (hazard ratio, 1.53; 95% confidence interval, 1.38 to 1.71; P\u2009&amp;lt;\u20090.001), 254 (43.6%) in the A+\/T+ group (hazard ratio, 2.25; 95% confidence interval, 1.97 to 2.56; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This longitudinal, population-level study emphasizes the adverse long-term outcomes of preoperative anaemia and perioperative red blood cell transfusion. It stresses the importance of an evidence-based, multimodal and multidisciplinary approach to conserving blood resources and optimizing outcomes in patients at high risk for transfusion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad403","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T17:14:31Z","timestamp":1701969271000},"source":"Crossref","is-referenced-by-count":7,"title":["The additive effects of anaemia and transfusion on long-term survival after coronary artery bypass surgery"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4876-5179","authenticated-orcid":false,"given":"Armando","family":"Abreu","sequence":"first","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Center\u2014UnIC@RISE, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8275-5500","authenticated-orcid":false,"given":"Jos\u00e9","family":"M\u00e1ximo","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Center\u2014UnIC@RISE, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"given":"Cl\u00e1udia","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"given":"Andr\u00e9","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Center\u2014UnIC@RISE, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Anesthesiology, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]},{"given":"Adelino","family":"Leite-Moreira","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Center\u2014UnIC@RISE, Faculty of Medicine of the University of Porto , Porto, Portugal"},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o University Hospital Center , Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"key":"2024030911292433800_ezad403-B1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1161\/CIRCULATIONAHA.106.653501","article-title":"Impact of preoperative anemia on outcome in patients undergoing coronary artery bypass graft surgery","volume":"116","author":"Kulier","year":"2007","journal-title":"Circulation"},{"key":"2024030911292433800_ezad403-B2","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1161\/CIRCULATIONAHA.109.854216","article-title":"Preoperative hemoglobin level as a predictor of survival after coronary artery 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