Individualized transfusion decisions to minimize adverse cardiovascular outcomes in patients with acute myocardial infarction and anemia
Authors' conclusion
The MINT trial average treatment effect, favoring a liberal strategy, may be optimal to minimize risk of 30-day death and death or MI for acute MI patients with anemia represented in the MINT sample as no individualized treatment effects were estimated on these outcomes. However, individualized transfusion strategy decisions have potential to reduce risk of 30-day MACE. External validation of the MACE algorithm is required before clinical use.
Study context
- Population
- Patients with acute MI and anemia randomized in the MINT (Myocardial Ischemia and Transfusion) trial between April 2017 to April 2023(98.4%) patients randomized in the MINT trial
- Participants
- 3,447 patients
- Comparison
- The expected population risk of an outcome under a scenario in which patients received their optimal treatment, as indicated by the individualized treatment effect, was contrasted with expected risks for universally applying a restrictive strategy or a liberal strategy to all patients.
Methodological detailsmachine learning methods
- Machine learning methods
Primary result
As reported in the abstract
30-day death and death or MI
- Baseline characteristics did not inform individualized treatment effects on 30-day death and death or MI, suggesting minimal heterogeneity in treatment effect on these outcomes
Further findings
| Outcome | Optimal treatment | Difference (percentage point) (95% CI) | |
|---|---|---|---|
| 30-day MACEOptimal treatmentvs restrictiveRisk reduction with optimal treatment | predicted risk 15.2% (95% CI 14.2%–16.2%) | −4.0% (−5.8 to −2.1) | |
| 30-day MACEOptimal treatmentvs liberalRisk reduction with optimal treatment | −2.3% (−3.7 to −0.9) | ||
| −10−505Difference, percentage point (linear scale) |
- 30-day major adverse cardiovascular events (MACE) — Algorithm baseline factors
- 12
Original publication
Individualized transfusion decisions to minimize adverse cardiovascular outcomes in patients with acute myocardial infarction and anemia. Am Heart J. Published 17 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →