Key Points

This Myocardial Ischemia and Transfusion (MINT) trial analysis evaluated the optimal transfusion strategy for patients with CKD and anemia experiencing acute myocardial infarction.In patients with CKD, a liberal transfusion strategy overall did not demonstrate benefit over a restrictive strategy.

Background

CKD is associated with higher risk of myocardial infarction and anemia. Among patients with anemia and CKD who experience myocardial infarction, it remains uncertain whether a liberal red blood cell transfusion threshold strategy (hemoglobin cutoff

Methods

Among the 3504 patients enrolled in the Myocardial Ischemia and Transfusion (MINT) trial with nonmissing serum creatinine, we compared baseline characteristics and 30-day and 6-month outcomes of patients without CKD (N=1279), CKD with eGFR 30–60 ml/min per 1.73 m2 (N=999), CKD with eGFR

Results

No statistically significant interactions were observed between CKD stage and assigned transfusion strategy. Among non–dialysis-dependent patients with an eGFR

Conclusions

In patients with CKD included in this MINT subgroup analysis, a liberal transfusion strategy was not worse than a restrictive transfusion strategy and was associated with less harm in subgroups not receiving dialysis.

Clinical Trial registry name and registration number:

Myocardial Ischemia and Transfusion (MINT), NCT02981407.