Hot off the NEJM press, published November 11, 2023:
Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia (Carson, Brooks, Hebert, et al Myocardial Ischemia and Transfusion (MINT) Investigators)
Phase 3 interventional trial
Adult patients with STEMI or NSTEMI and Hgb <10 g/dL were randomly assigned to either of two strategies
restrictive transfusion- threshold of 7-8 g/dL (transfusion was permitted but not required when the hemoglobin level was less than 8 and was strongly recommended when the level was less than 7 or when anginal symptoms were not controlled with medications)
liberal transfusion- threshold of 10 g/dL
Primary outcome measured was recurrent MI or death at 30 days
3504 pateints were included in this study. A primary-outcome event occurred in 295 of 1749 patients (16.9%) in the restrictive-strategy group and in 255 of 1755 patients (14.5%) in the liberal-strategy group. More specifically, death occurred in 9.9% of the patients with the restrictive strategy and in 8.3% of the patients with the liberal strategy; myocardial infarction occurred in 8.5% and 7.2% of the patients, respectively.
Conclusions from the study: Liberal transfusion strategy did NOT significantly reduce the risk of recurrent MI or death at 30 days.
References
N Engl J MedCarson JL, Brooks MM, Hébert PC, et al. Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia. . Published online November 11, 2023. doi:10.1056/NEJMoa2307983
