Liberal Transfusion May Benefit Patients With MI and Anemia

A liberal transfusion strategy may reduce 30-day death or recurrent myocardial infarction among patients with myocardial infarction and anemia, according to a post hoc Bayesian analysis of the MINT randomized clinical trial.

The analysis included 3504 MINT participants and compared posterior probabilities for benefit and harm with liberal versus restrictive transfusion. The liberal approach was evaluated for the probability of at least 1 fewer death or MI per 100 treated, while heart failure was assessed as a potential tradeoff.

The investigators found that the posterior probability of at least 1 fewer death or MI per 100 treated ranged from 62.7% to 90.4% with the liberal strategy. The probability of at least 1 additional heart failure event per 100 treated ranged from 13.3% to 29.3%.

The authors concluded that a liberal strategy was associated with lower risk of 30-day death or MI and that this possible benefit outweighed the increased risk of heart failure in the analysis.

The findings support individualized transfusion decisions for patients with MI and anemia, incorporating guideline recommendations, clinical risk, and patient values.

Sources:Bertolet M, Carrier FM, Glynn S, et al. Restrictive vs liberal transfusion strategy after myocardial infarction: a post hoc analysis of the MINT randomized clinical trial. JAMA Netw Open. 2026;9(7):e2624991. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2852120