Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial

Tabassome Simon¹, Brandon M Herbert², Maria Mori Brooks², Shaun G Goodman^{3

4}, John H Alexander⁵, Philippe Gabriel Steg⁶, Renato D Lopes^{5

7}, Shahab Ghafghazi⁸, Claire Bouleti⁹, Howard A Cooper¹⁰, Eric L McCamant¹¹, Kevin R Bainey¹², Herbert D Aronow¹³, J Dawn Abbott¹⁴, Caroline Alsweiler¹⁵, Marnie Bertolet², Dean A Fergusson¹⁶, Andrew M Goldsweig¹⁷, Paul C Hébert^{18

19}, Jeffrey L Carson²⁰; MINT Trial Investigators

Affiliations

¹ Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Department of Clinical Pharmacology and Department of Clinical Research Platform of East of Paris, French Alliance for Cardiovascular Trials (FACT) (T.S.).
² Department of Epidemiology, University of Pittsburgh, PA (B.M.H., M.M.B., M.B.).
³ St. Michael's Hospital, Unity Health and Peter Munk Cardiac Centre, University Health Network, University of Toronto, ON, Canada (S.G.G.).
⁴ Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.).
⁵ Duke Clinical Research Institute, Duke University, Durham, NC (J.H.A., R.D.L.).
⁶ Université Paris-Cité, Assistance Publique-Hôpitaux de Paris, FACT, INSERM U1148, France (P.G.S.).
⁷ Brazilian Clinical Research Institute, São Paulo (R.D.L.).
⁸ University of Louisville, KY (S.G.).
⁹ University Hospital of Poitiers, Clinical Investigation Center (INSERM 1402), Cardiology Department, French Alliance for Cardiovascular Trials (FACT), France (C.B.).
¹⁰ Department of Cardiology, Westchester Medical Center, Valhalla, NY (H.A.C.).
¹¹ Lancaster General Health, PA (E.L.M.).
¹² Mazankowski Alberta Heart Institute, University of Alberta Hospital, Edmonton, Canada (K.R.B.).
¹³ Henry Ford Health, Michigan State University College of Human Medicine, Detroit (H.D.A.).
¹⁴ Rhode Island Hospital, Providence (J.D.A.).
¹⁵ Green Lane Coordinating Center, Auckland, New Zealand (C.A.).
¹⁶ Ottawa Hospital Research Institute, ON, Canada (D.A.F.).
¹⁷ Baystate Medical Center and University of Massachusetts-Baystate, Springfield (A.M.G.).
¹⁸ Bruyere Research Institute, University of Ottawa, ON, Canada (P.C.H.).
¹⁹ Centre de recherche du Centre hospitalier de l'Université de Montréal, QB, Canada (P.C.H.).
²⁰ Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (J.L.C.).

PMID: 39221566
PMCID: PMC11548830
DOI: 10.1161/CIRCULATIONAHA.124.069917

Randomized Controlled Trial

Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial

Tabassome Simon et al. Circulation. 2024.

. 2024 Sep 24;150(13):1064-1066.

doi: 10.1161/CIRCULATIONAHA.124.069917. Epub 2024 Sep 2.

Authors

Affiliations

¹ Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Department of Clinical Pharmacology and Department of Clinical Research Platform of East of Paris, French Alliance for Cardiovascular Trials (FACT) (T.S.).
² Department of Epidemiology, University of Pittsburgh, PA (B.M.H., M.M.B., M.B.).
³ St. Michael's Hospital, Unity Health and Peter Munk Cardiac Centre, University Health Network, University of Toronto, ON, Canada (S.G.G.).
⁴ Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.).
⁵ Duke Clinical Research Institute, Duke University, Durham, NC (J.H.A., R.D.L.).
⁶ Université Paris-Cité, Assistance Publique-Hôpitaux de Paris, FACT, INSERM U1148, France (P.G.S.).
⁷ Brazilian Clinical Research Institute, São Paulo (R.D.L.).
⁸ University of Louisville, KY (S.G.).
⁹ University Hospital of Poitiers, Clinical Investigation Center (INSERM 1402), Cardiology Department, French Alliance for Cardiovascular Trials (FACT), France (C.B.).
¹⁰ Department of Cardiology, Westchester Medical Center, Valhalla, NY (H.A.C.).
¹¹ Lancaster General Health, PA (E.L.M.).
¹² Mazankowski Alberta Heart Institute, University of Alberta Hospital, Edmonton, Canada (K.R.B.).
¹³ Henry Ford Health, Michigan State University College of Human Medicine, Detroit (H.D.A.).
¹⁴ Rhode Island Hospital, Providence (J.D.A.).
¹⁵ Green Lane Coordinating Center, Auckland, New Zealand (C.A.).
¹⁶ Ottawa Hospital Research Institute, ON, Canada (D.A.F.).
¹⁷ Baystate Medical Center and University of Massachusetts-Baystate, Springfield (A.M.G.).
¹⁸ Bruyere Research Institute, University of Ottawa, ON, Canada (P.C.H.).
¹⁹ Centre de recherche du Centre hospitalier de l'Université de Montréal, QB, Canada (P.C.H.).
²⁰ Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ (J.L.C.).

PMID: 39221566
PMCID: PMC11548830
DOI: 10.1161/CIRCULATIONAHA.124.069917

No abstract available

Keywords: anemia; erythrocyte transfusion; myocardial infarction.

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Conflict of interest statement

Dr Simon reports research grant support to her institution from Novartis, Sanofi, Merck, AstraZeneca, Lilly, Daichy-Sankyo, Glaxo-Smith-Kline, and French Ministry of Health, as well as speaker or consulting honoraria (eg, Data and Safety Monitoring Board, Advisory Board, and Educational Events) from Ablative Solutions, Air Liquide, AstraZeneca, Sanofi, Servier Novartis, and 4Living Biotech. Drs Brooks, Hébert, and Carson were Data and Safety Monitoring Board members for Cerus Corp. Dr Goodman reports research grant support (eg, Steering Committee or Data and Safety Monitoring Committee) and/or speaker/consulting honoraria (eg, advisory boards) from Amgen, Anthos Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, CYTE Ltd, Daiichi-Sankyo/American Regent, Eli Lilly, Esperion, Ferring Pharmaceuticals, HLS Therapeutics, Idorsia, JAMP Pharma, Merck, Novartis, Novo Nordisk A/C, Pendopharm/Pharmascience, Pfizer, Regeneron, Sanofi, Servier, Tolmar Pharmaceuticals, and Valeo Pharma, as well as salary support/honoraria from the Canadian Heart Failure Society, Canadian Heart Research Centre and MD Primer, Canadian VIGOUR Centre, Cleveland Clinic Coordinating Centre for Clinical Research, Duke Clinical Research Institute, New York University Clinical Coordinating Centre, PERFUSE Research Institute, Peter Munk Cardiac Centre Clinical Trials and Translation Unit, and TIMI Study Group (Brigham Health). Dr Alexander received research grants to Duke University from Artivion/CryoLife, Bayer, Bristol-Myers Squibb, CSL Behring, Ferring, the US Food and Drug Administration, Humacyte, and the National Institutes of Health, as well as Advisory Board or consulting payments from AbbVie, Artivion/CryoLife, AtriCure, Bayer, Bristol-Myers Squibb, Eli Lilly, Ferring, GlaxoSmithKline, Janssen, Novostia, Pfizer, Portola, Theravance, and Veralox. Dr Steg received research grants from Bayer, Merck, Sanofi, and Servier; has been a speaker or consultant for Amarin, Amgen, AstraZeneca, Bayer, Bristol-Myers-Squibb, Janssen, Lexicon, Merck, Novartis, Novo-Nordisk, PhaseBio, Pfizer, Regeneron, and Sanofi, Servier; and has been senior associate editor for Circulation. Dr Lopes reports research grants or contracts from Amgen, Bristol-Myers Squibb, GlaxoSmithKline, Medtronic, Pfizer, and Sanofi-Aventis; funding for educational activities or lectures from Pfizer, Daiichi Sankyo, and Novo Nordisk; and funding for consulting or other services from Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Novo Nordisk. Dr Bouleti received research grants or contract from Janssen and Pfizer, plus consulting and lecture fees from AstraZeneca, Novartis, Boehringer-Ingelheim, Sanofi, Bayer, and Bristol-Myers Squibb. Dr Abbott reports consulting for Abbott, Medtronic, Penumbra. Research Boston Scientific, Recor, Med Alliance, Shockwave, and Microport. C. Alsweiler reports consulting for Duke University. Dr Goldsweig received consulting fees from Philips and Inari and medical speaking fees from Philips and Edwards Lifesciences. The other authors report no conflicts.

Figures

**Figure 1:**
Cumulative Incidence Function Estimates for All-Cause Death (1A), and for Cause-Specific Death (cardiac cause of death (1B), non-cardiac cause (1C), unknow cause of death (1D) by Assigned Transfusion Strategy (Landmark).

See this image and copyright information in PMC

References

1. Carson JL, Stanworth SJ, Guyatt G, Valentine S, Dennis J, Bakhtary S, Cohn CS, Dubon A, Grossman BJ, Gupta GK, et al. Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. 2023;330:1892–1902 - PubMed
1. Ducrocq G, Gonzalez-Juanatey JR, Puymirat E, Lemesle G, Cachanado M, Durand-Zaleski I, Arnaiz JA, Martínez-Sellés M, Silvain J, Ariza-Solé A, et al. Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial. JAMA 2021;325:552–560 - PMC - PubMed
1. Cooper HA, Rao SV, Greenberg MD, Rumsey MP, McKenzie M, Alcorn KW; Panza JA Conservative versus liberal red cell transfusion in acute myocardial infarction (the CRIT Randomized Pilot Study. Am J Cardiol 2011;108:1108–1111 - PubMed
1. Carson JL, Brooks MM, Hébert PC, Goodman SG, Bertolet M, Glynn SA, Chaitman BR, Simon T, Lopes RD, Goldsweig AM, et al. Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia. N Engl J Med. 2023;389:2446–2456. - PMC - PubMed
1. Carson JL, Brooks MM, Chaitman BR, Alexander JH, Goodman SG, Bertolet M, Abbott JD, Cooper HA, Rao SV, Triulzi DJ, et al. Rationale and design for the myocardial ischemia and transfusion (MINT) randomized clinical trial. Am Heart J. 2023;257:120–129. - PMC - PubMed

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Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial

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Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial

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Conflict of interest statement

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