Restrictive vs Liberal Transfusion Strategy After Myocardial Infarction

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)? 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%. 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.

Corresponding Author: Marnie Bertolet, PhD, Epidemiology Data Center, University of Pittsburgh, 4420 Bayard St, Ste 600, Pittsburgh, PA 15260 (Mhb12@pitt.edu).

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