Liberal blood transfusion strategy does not improve outcomes in acute MI patients with anemia: MINT study

A total of 3504 patients were included in the study. The mean hemoglobin level was 1.3 to 1.6 g per deciliter lower in the restrictive-strategy group than in the liberal-strategy group.

The occurrence of primary-outcome was not significantly different between the two groups (16.9% in the restrictive-strategy group and 14.5% in the liberal-strategy group).

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- both differences being not significant.

The trial population mimics patients seen in clinical practice!

“It was pragmatic, since it was designed to maximize the generalizability of the results. With few exclusions, the enrollment of 3504 patients included a wide variety of older patients who had a variety of myocardial infarction diagnoses, including both ST-segment elevation and non–ST-segment elevation and both type 1 and type 2 myocardial infarctions. In addition, the patients had many coexisting illnesses and were generally representative of patients in clinical practice with acute myocardial infarction and anemia”, noted the authors.

The authors conclude with “(the) trial end points suggest some benefit of a liberal strategy over a restrictive strategy, but additional studies would be needed to confirm that conclusion.

Source: NEJM: DOI: 10.1056/NEJMoa2307983