Does a Liberal Transfusion Strategy in Patients with Myocardial Infarction and Anemia Improve Outcomes?

The largest trial to date of liberal versus restrictive transfusion thresholds in patients with myocardial infarction (MI) and anemia, the MINT trial, was inconclusive but suggested benefit of liberal transfusion in a subset of patients with type I MI (NEJM JW Gen Med Dec 15 2023 and N Engl J Med 2023; 389:2446). Now, the same authors report combined data from 4300 patients (mean age, 72) from four trials of liberal and restrictive transfusion thresholds (hemoglobin, <10 g/dL vs. 7–8 g/dL).

Key findings were as follows:

• The primary outcome of all-cause death or recurrent MI within 30 days was not significantly different in the liberal and restrictive groups (14% vs. 15%).

• Cardiac-related death at 30 days occurred less often in the liberal grou…