Blood loss from coronary angiography increases transfusion requirements for coronary artery bypass graft surgery

Objective: To determine the blood loss associated with coronary angiography and its impact on hemoglobin and transfusion requirements for subsequent coronary artery bypass graft (CABG) surgery. Design: Retrospective chart review. Setting: Tertiary-care, academic medical center. Participants: A total of 506 adult patients undergoing coronary angiography and CABG surgery. Interventions: None (observational study). Measurements and Main Results: Coronary angiography was associated with a reduction in hemoglobin of 1.8 g/dL. This reduction in hemoglobin was a significant predictor of allogeneic red blood cell transfusion. Conclusion: Coronary angiography contributes to a 1.8 g/dL reduction in hemoglobin concentration before CABG surgery and was associated with increased transfusion of allogeneic blood products. Measures aimed at maintaining red cell volume during coronary angiography, increasing erythropoiesis, or delaying surgery beyond 2 weeks may result in a decrease in transfusion requirements for patients undergoing CABG surgery.