Effect of Red Blood Cell Transfusion Strategy on Clinical Outcomes Among Patients With Acute Myocardial Infarction Undergoing Revascularization: A Prespecified Analysis of the MINT Trial
Authors' conclusion
In this analysis of the MINT trial, revascularization did not alter the effect of the randomized transfusion strategy on 30-day death or MI. The hypothesis-generating finding that a restrictive transfusion strategy was associated with an increased risk of cardiac death among patients with anemia and acute MI who do not undergo revascularization requires confirmation.
Study context
- Population
- Patients with acute myocardial infarction (MI) and hemoglobin ≤10 g/dL, by revascularization before randomization during index hospitalization
- Participants
- 3,504 MINT trial randomized participants
- Comparison
- Restrictive vs liberal transfusion by revascularization status
- Revascularizationn = 1,002
- No revascularizationn = 2,442
- Primary endpoint
- Death or MI
- Follow-up
- 30-day
Methodological detailsrandomized, multivariable log-binomial regression with interaction terms
- Randomized
- Multivariable log-binomial regression with interaction terms
Primary result
As reported in the abstract
- No significant interaction between revascularization and assigned transfusion strategy
Secondary outcomes
| Outcome | Relative risk (CI) | |
|---|---|---|
| Cardiac death · 30-dayRestrictivevs liberalNonrevascularized patients | 2.45 (1.58–3.81) | |
| Cardiac death · 30-dayRestrictivevs liberalRevascularized patients | 0.97 (0.59,–1.60) | |
| 0.20.5125Relative risk (log scale) |
- Cardiac death: interaction P =0.006
Baseline characteristics
- Patients undergoing revascularization were younger, more often female, and had fewer comorbidities
Original publication
Effect of Red Blood Cell Transfusion Strategy on Clinical Outcomes Among Patients With Acute Myocardial Infarction Undergoing Revascularization: A Prespecified Analysis of the MINT Trial. Circ Cardiovasc Interv. Published 30 March 2025. doi:10.
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