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 | Circulation: Cardiovascular Interventions
Background: The Myocardial Ischemia and Transfusion (MINT) Trial (N=3504) randomized patients with acute MI and a hemoglobin ≤ 10 g/dL to liberal (maintain Hgb ≥ 10 g/dL) or restrictive (maintain Hgb ≥ 8 g/dL) red blood cell transfusion. The results suggested a benefit on 30-day death or MI with a liberal transfusion strategy. The effect of transfusion in acute MI patients undergoing revascularization is unclear. Methods: In this pre-specified analysis of the MINT trial, patients who underwent revascularization (N=1002) before randomization but during index hospitalization were compared with those who did not (N=2442). The primary outcome was 30-day death or MI; secondary outcomes included 30-day death, recurrent MI, the composite of death, recurrent MI, ischemia driven unscheduled revascularization, or readmission for ischemic cardiac diagnosis, heart failure, and cardiac death. Multivariable log binomial regression was used to determine the relative risks of the primary and secondary