{"id":"45987","type":"article","url":"https://hartvaat.nl/2026/05/18/mint-post-hoc-bloedtransfusie-strategie-bij-infarct-anemie-heeft-geen-sekse-spec/","title":"MINT post-hoc: bloedtransfusie-strategie bij infarct + anemie heeft geen sekse-specifiek effect","title_en":"Comparative Efficacy of Transfusion Strategies in Women and Men With Myocardial Infarction and Anemia: Prespecified Secondary Findings From the MINT Trial","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":[],"journal":"Circulation","doi":"https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078320","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078320","authors":[],"significance":7,"published":"2026-07-08","source_date":"2026-05-18","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/mitralisregurgitatie/","https://hartvaat.nl/kennis/kleplijden/mitraclip-transcatheter-mitralisreparatie/"],"congress":"","summary_en":"Prespecified secondary analysis of the MINT trial in 3,504 patients with acute myocardial infarction (AMI) and anaemia randomised to restrictive or liberal transfusion thresholds. 1,593 (45.4%) were women. Women received fewer transfusions on average. The primary endpoint (30-day death or MI) occurred in 15.4% of both women and men — no significant sex interaction (p=0.60). 180-day mortality was lower in women (11.0% vs 13.5%; p=0.04). For 30-day cardiac death, men had higher risk in the restrictive arm (RR 2.34; 95% CI 1.48-3.70; interaction p=0.05) — a suggestion that men may be more vulnerable to a restrictive transfusion strategy in AMI. Overall, the findings support sex-neutral transfusion thresholds in current practice.","created":"2026-07-03T20:27:02Z","updated":"2026-07-04T19:27:15Z","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":"Vooraf gespecificeerde secundaire analyse van de MINT-trial bij 3.504 patiënten met acuut myocardinfarct (AMI) en anemie, gerandomiseerd tussen restrictieve en liberale transfusie-drempel. 1.593 (45,4%) waren vrouwen. Vrouwen ontvingen gemiddeld minder transfusies. Het primaire eindpunt (30-daagse sterfte of MI) trad op bij 15,4% van zowel vrouwen als mannen — geen significante interactie met sekse (p=0,60). 180-daagse sterfte was lager bij vrouwen (11,0% vs 13,5%; p=0,04). Voor 30-daagse cardiale sterfte was er bij mannen wel een hoger risico in de restrictieve arm (RR 2,34; 95%-BI 1,48-3,70; interactie p=0,05) — een suggestie dat mannen kwetsbaarder zijn voor restrictieve transfusiebeleid bij AMI. Overall ondersteunen de bevindingen sekse-neutrale transfusiedrempels in de huidige praktijk.","abstract_original":"BACKGROUND:The optimal transfusion strategy in patients with acute myocardial infarction (AMI) and anemia may be influenced by sex differences in pathophysiology and cardiovascular outcomes. The Myocardial Ischemia and Transfusion trial (MINT) randomized patients with AMI and anemia to restrictive or liberal transfusion thresholds, but sex-stratified outcomes remain undefined. The objective was to evaluate whether the clinical effect of restrictive versus liberal red blood cell transfusion strategies differs by sex in patients hospitalized with AMI and anemia.METHODS:In this prespecified secondary analysis of the MINT trial, we examined outcomes by sex and transfusion strategy. The primary outcome was 30-day composite death or MI. Secondary outcomes included heart failure, stroke, cardiac death, and 180-day mortality. Adjusted relative risks (RRs) and hazard ratios (HRs) were estimated accounting for sex differences at baseline. Interactions between sex and transfusion effects were assessed.RESULTS:There were 3504 study participants, of whom 1593 (45.4%) were women. Women received fewer transfusions on average. Primary outcome occurred in 15.4% of women and 15.4% of men and occurred in 16.5% of women and 17.1% of men in the restrictive arm, versus 14.9% and 14.2% in the liberal arm, respectively. Women had a lower 180-day mortality (11.0% versus 13.5%;P=0.04). There were no statistically significant interactions between sex and transfusion strategy for the primary outcome (interactionP=0.60). For 30-day cardiac death, a higher RR in men was observed in the restrictive transfusion arm (RR, 2.34; 95% CI, 1.48–3.70; interactionP=0.05).CONCLUSIONS:For MINT patients with anemia and AMI, women comprised nearly half of the study population, and randomization to a restrictive or liberal transfusion strategy resulted in comparable outcomes in women and men. These findings support sex-neutral transfusion thresholds.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT02981407."}