Coronary disease & ACSRandomised controlled trial
Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia
- Randomised controlled trial
- phase 3
Authors' conclusion
In patients with acute myocardial infarction and anemia, a liberal transfusion strategy did not significantly reduce the risk of recurrent myocardial infarction or death at 30 days. However, potential harms of a restrictive transfusion strategy cannot be excluded.
Study context
- Population
- Patients with MI and Hb <10 g per deciliterprimary analysis
- Participants
- 3,504 patients
- Comparison
- Restrictive vs liberal transfusion strategy
- Restrictiven = 1,749
- Liberaln = 1,755reference
- Primary endpoint
- Composite of:
- MI
- Death
- Follow-up
- 30 days
Primary result
As reported in the abstract
Relative risk
1.15
95% CI 0.99–1.34
P = 0.07
Events by treatment group
Restrictive vs Liberal
RR 1.15 (95% CI 0.99–1.34); P = 0.07
Further findings
Red-cell units transfused
| Outcome | Restrictive | Liberal | RR (95% CI) | |
|---|---|---|---|---|
| Death | 9.9% | 8.3% | 1.19 (0.96–1.47) | |
| MI | 8.5% | 7.2% | 1.19 (0.94–1.49) | |
| 0.512Relative risk (log scale) |
Mean Hb level, days 1 to 3 · days 1 to 3 after randomization
- Mean Hb lower with Restrictive vs Liberal
- 1.3 to 1.6 g per deciliter
Original publication
Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia. N Engl J Med. Published 11 November 2023. doi:10.1056/nejmoa2307983
Summarised from the published abstract; every number is checked against it