{"id":31478,"date":"2026-11-01T04:06:00","date_gmt":"2026-10-31T20:06:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31478"},"modified":"2026-11-02T05:43:50","modified_gmt":"2026-11-01T21:43:50","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%bf%83%e8%82%8c%e6%a2%97%e5%a1%9e%e5%90%8e%e7%9a%84%e9%99%90%e5%88%b6%e6%80%a7%e4%b8%8e%e8%87%aa%e7%94%b1%e6%80%a7%e8%be%93%e8%a1%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31478","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u5fc3\u808c\u6897\u585e\u540e\u7684\u9650\u5236\u6027\u4e0e\u81ea\u7531\u6027\u8f93\u8840\u7b56\u7565"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Cardiology<\/p>\n\n\n\n

Restrictive vs Liberal Transfusion Strategy After Myocardial Infarction: A Post Hoc Analysis of the MINT Randomized Clinical Trial<\/h1>\n\n\n\n

Marnie Bertolet, Francois Martin Carrier, Simone Glynn, et al<\/h3>\n\n\n\n

JAMA Netw Open 2026;9;(7):e2624991. doi:10.1001\/jamanetworkopen.2026.24991<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the posterior probability that a liberal vs restrictive transfusion strategy is associated with reduced risk of 30-day death or myocardial infarction (MI)?<\/p>\n\n\n\n

Findings<\/strong>  This post hoc analysis of 3504 participants in the MINT randomized clinical trial found that for the liberal vs restrictive strategy, the posterior probability of least 1 less death or MI per 100 treated was 62.7% to 90.4%. The probability of least 1 more heart failure event per 100 treated was 13.3% to 29.3%.<\/p>\n\n\n\n

Meaning<\/strong>  This study suggests that, consistent with guideline recommendations, a liberal transfusion strategy may be reasonable for some patients as its net benefit, after treating 200 patients, is 5 fewer deaths or MIs and 1 more heart failure event.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  The decision to transfuse a patient with myocardial infarction (MI) and anemia at a higher vs lower hemoglobin threshold must consider the potential benefit of reduced risk of 30-day death or MI and the potential risk of heart failure.<\/p>\n\n\n\n

Objectives<\/strong>  To estimate bayesian posterior risk differences and posterior probabilities that a liberal vs restrictive transfusion strategy is associated with reduced risk of 30-day death or MI and whether the probabilities exceed predefined thresholds.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  The Myocardial Ischemia and Transfusion (MINT) trial recruited adults from April 26, 2017, to April 14, 2023, who were hospitalized with MI and anemia at 144 sites in 6 countries. Statistical analysis was performed from July 31, 2024, to February 18, 2026.<\/p>\n\n\n\n

Intervention<\/strong>  The MINT trial randomized participants to a restrictive (transfuse if hemoglobin is <7 to 8 g\/dL) or liberal (maintain hemoglobin at >10 g\/dL) transfusion strategy.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Bayesian posterior risk differences were estimated for 30-day death or MI and for heart failure using 3 prior beliefs regarding the treatment strategies: noninformative, liberal strategy superiority, or restrictive strategy superiority.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0The mean (SD) age of the 3504 participants was 72.1 (11.6) years and 1911 (54.5%) were men. Compared with the restrictive strategy, the risk of 30-day death or MI with the liberal strategy was 1.4% (95% credible interval, \u22120.8% to 3.5%) to 2.4% (95% credible interval, 0.3%-4.6%) lower, depending on prior beliefs. The probability that the liberal strategy was associated with a lower risk of 30-day death or MI ranged from 89.1% to 98.8%, and the probability that a liberal strategy was associated with at least 1 less death or MI per 100 treated was between 62.7% and 90.4%. Conversely, the risk of heart failure with the liberal strategy was 0.2% (95% credible interval, \u22121.6% to 1.2%) to 0.6% (95% credible interval, \u22122.0% to 0.8%) higher compared with the restrictive strategy, depending on prior beliefs. The probability that the liberal strategy was associated with a higher risk of heart failure ranged from 60.6% to 80.0%, and the probability that a liberal strategy was associated with at least 1 more heart failure event per 100 treated was between 13.3% and 29.3%.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  This post hoc analysis of a randomized clinical trial of patients with MI and anemia suggests that a liberal transfusion strategy was associated with a lower risk of 30-day death or MI, outweighing the increased risk of heart failure. Consistent with guideline recommendations and according to patients\u2019 values and clinician risk assessment, a liberal transfusion strategy may be reasonable.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT02981407<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Cardiology Restrictive vs […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31478"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31478"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31478\/revisions"}],"predecessor-version":[{"id":31853,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31478\/revisions\/31853"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}