Liberal transfusion strategy does not significantly reduce the risk for recurrent myocardial infarction or death
By Elana Gotkine HealthDay Reporter
TUESDAY, Nov. 14, 2023 (HealthDay News) — For patients with acute myocardial infarction and anemia, a liberal transfusion strategy does not significantly reduce the risk for recurrent myocardial infarction or death compared with a restrictive strategy, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.
Jeffrey L. Carson, M.D., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues conducted a phase 3 interventional trial involving patients with myocardial infarction and a hemoglobin level of less than 10 g/dL. A total of 3,504 participants were randomly assigned to a restrictive transfusion strategy (hemoglobin cutoff for transfusion, 7 or 8 g/dL) or a liberal transfusion strategy (hemoglobin cutoff, <10 g/dL).
The researchers found that 16.9 percent of 1,749 patients in the restrictive-strategy group and 14.5 percent of 1,755 in the liberal-strategy group had a primary outcome event (composite of myocardial infarction or death at 30 days; risk ratio model with multiple imputation for incomplete follow-up, 1.15; 95 percent confidence interval, 0.99 to 1.34; P = 0.07). There was no significant difference seen in the occurrence of death or myocardial infarction with the restrictive strategy versus liberal strategy (9.9 versus 8.3 percent and 8.5 versus 7.2 percent, respectively).
“Trial end points suggest some benefit of a liberal strategy over a restrictive strategy, but additional studies would be needed to confirm that conclusion,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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