Transfusion Strategy Effect on Quality of Life in Patients With Myocardial Infarction and Anemia: A Secondary Analysis of the MINT Randomized Clinical Trial
An erratum to this article was published (JAMA Intern Med, 1 Nov 2025 ↗)
Authors' conclusion
This secondary analysis of the MINT trial found that in patients with MI and anemia, a liberal transfusion strategy compared with a restrictive transfusion strategy did not affect QOL outcomes 30 days after randomization. This suggests that higher Hb levels maintained with RBC transfusion may not offer significant benefits to QOL overall in patients with MI and anemia. Additional studies may be useful for further examining and validating transfusion’s effect on QOL in patients with MI and heart failure.
Study context
- Population
- Hospitalized adults with acute myocardial infarction (MI) and anemia (hemoglobin [Hb] less than 10 g/dL)included patients (those with quality of life (QOL) data and those who died before 30-day follow-up), of 3504 randomized in the MINT trial · QOL data, restrictive group 1,254 · QOL data, liberal group 1,271 · died before 30-day follow-up 319
- Participants
- 2,844 adults
- Comparison
- Liberal vs restrictive red blood cell (RBC) transfusion strategy
- Liberaln = 1,271
- Restrictiven = 1,254
Methodological detailsprespecified secondary outcome, 144 sites across 6 countries
- Prespecified secondary outcome
- 144 sites across 6 countries
Primary result
As reported in the abstract
- No differences between assigned transfusion strategies
Secondary outcomes
No problems vs any problem, usual activities domain · 30 days postrandomization · not statistically significant
No problems vs any problem, mobility domain · 30 days postrandomization · not statistically significant
No problems vs any problem, self-care domain · 30 days postrandomization · not statistically significant
Mean differences in any QOL outcome (adjusted mixed-effects linear regressions)
- No association between assigned transfusion strategy and mean differences in any QOL outcome
Health Today rating, by history of heart failure (prespecified subgroup)
- β, history of heart failure
- 2.06 [95% CI, −0.23 to 4.35]
- β, comparison subgroup
- −1.44 [95% CI, −3.81 to 0.92]
- P = .04
- Liberal strategy associated with better QOL scores in functional capacity domains; only statistically significant in patients with a history of heart failure
Original publication
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