# Restrictief versus liberaal transfusiebeleid bij type 1 versus type 2 MI: REALITY subanalyse

*geplaatst 2024-12-03 · Algemeen · Circulation · doi 10.1161/CIRCULATIONAHA.124.071208 · https://hartvaat.nl/2024/12/03/restrictief-versus-liberaal-transfusiebeleid-bij-type-1-versus-type-2-mi-reality/*

REALITY subanalyse toonde dat restrictief transfusiebeleid veilig is bij zowel type 1 als type 2 MI. Het MI-subtype modificeert de transfusiestrategie niet.

## English: Restrictive Versus Liberal Transfusion in Patients With Type 1 or Type 2 Myocardial Infarction: A Prespecified Analysis of the MINT Trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Circulation, https://doi.org/10.1161/CIRCULATIONAHA.124.071208. Bijgewerkt 2026-07-03T13:30:22Z. 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.