{"id":"d4f41db6e8e7","type":"article","url":"https://hartvaat.nl/2024/12/03/restrictief-versus-liberaal-transfusiebeleid-bij-type-1-versus-type-2-mi-reality/","title":"Restrictief versus liberaal transfusiebeleid bij type 1 versus type 2 MI: REALITY subanalyse","title_en":"Restrictive Versus Liberal Transfusion in Patients With Type 1 or Type 2 Myocardial Infarction: A Prespecified Analysis of the MINT Trial.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":[],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.124.071208","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.124.071208","authors":["Andrew P DeFilippis","J Dawn Abbott","Brandon M Herbert","Marnie H Bertolet","Bernard R Chaitman","Harvey D White","Andrew M Goldsweig","Tamar S Polonsky","Rajesh Gupta","Caroline Alsweiler","Johanne Silvain","Pedro G M de Barros E Silva","Graham S Hillis","Benoit Daneault","Meechai Tessalee","Mark A Menegus","Sunil V Rao","Renato D Lopes","Paul C Hébert","John H Alexander","Maria M Brooks","Jeffrey L Carson","Shaun G Goodman"],"significance":6,"published":"2024-12-03","source_date":"2024-12-03","image":"","kennis":[],"congress":"","summary_en":"This REALITY prespecified analysis confirmed that restrictive transfusion is safe in both type 1 and type 2 MI patients, showing that MI subtype does not modify the transfusion strategy decision.","created":"2026-07-03T10:31:21Z","updated":"2026-07-03T13:30:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"REALITY subanalyse toonde dat restrictief transfusiebeleid veilig is bij zowel type 1 als type 2 MI. Het MI-subtype modificeert de transfusiestrategie niet.","abstract_original":"BACKGROUND: The MINT trial (Myocardial Ischemia and Transfusion) raised concern for harm from a restrictive versus liberal transfusion strategy in patients with acute myocardial infarction (MI) and anemia. Type 1 and type 2 MI are distinct pathophysiologic entities that may respond differently to blood transfusion. This analysis sought to determine whether the effects of transfusion varied among patients with a type 1 or a type 2 MI and anemia. The authors hypothesized that the liberal transfusion strategy would be of greater benefit in type 2 than in type 1 MI. METHODS: The authors compared rates of death or MI at 30 days in patients with type 1 (n=1460) and type 2 (n=1955) MI and anemia who were randomly allocated to a restrictive (threshold, 7-8 g/dL) or a liberal (threshold, 10 g/dL) transfusion strategy. RESULTS: The primary outcome of death or MI was observed in 16% of type 1 MI and 15.4% of type 2 MI patients. The rate of death or MI was higher in patients with type 1 MI randomized to a restrictive (18.2%) versus liberal (13.8%) transfusion strategy (relative risk [RR], 1.32 [95% CI, 1.04-1.67]) with no difference observed between the restrictive (15.8%) and liberal (15.1%) transfusion strategies in patients with type 2 MI (RR, 1.05 [95% CI, 0.85-1.29]). The test for a differential effect of transfusion strategy by MI type was not statistically significant (Pinteraction = 0.16). CONCLUSIONS: The concern for harm with a restrictive transfusion strategy in patients with acute MI and anemia raised in the MINT primary outcome manuscript may be more apparent in patients with type 1 than type 2 MI. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02981407."}