Written by Mary Marschner
Spoon Feed
A transfusion threshold hemoglobin <10 vs. 7-8 for patients with anemia and MI does not affect quality-of-life scores after 30 days.
Long-lasting MINT
Coronary artery disease, MI, and anemia can impact energy levels and cause shortness of breath, which in turn affect quality of life. The MINT RCT found there was no difference in the outcomes of anemic patients who had MIs with a liberal transfusion strategy (Hgb <10) vs. a restrictive strategy (Hgb 7-8).
In this prespecified secondary analysis of the MINT RCT (n = 2,844; mean age 71.9 years), researchers evaluated whether a liberal transfusion strategy (Hgb threshold <10 g/dL) vs. a restrictive strategy (7–8 g/dL) influenced health-related quality of life (EQ-5D-5L) at 30 days post-myocardial infarction. No significant differences were observed in overall scores or individual domains. In pre-specified subgroups, only those with baseline heart failure showed a modest Health Today improvement (β 2.06; 95%CI −0.23 to 4.35; P=0.04).
This was a nicely done RCT with very thoughtful subgroup analysis. They compared type of MI, intervention done, and acute vs. chronicity of anemia, and although they had some differences, none were statistically significant.
How does this change my practice?
This study affirms my current practice of a Hgb goal of 8 for patients with anemia and coronary artery disease.
Source
Transfusion Strategy Effect on Quality of Life in Patients With Myocardial Infarction and Anemia: A Secondary Analysis of the MINT Randomized Clinical Trial. JAMA Intern Med. 2025 Jun 3:e250654. doi: 10.1001/jamainternmed.2025.0654. Epub ahead of print. PMID: 40459491
