Evidence map›Paper›PMID 39348705›Full record

Trial reportAnnals of internal medicine2024

Effect of Four Hemoglobin Transfusion Threshold Strategies in Patients With Acute Myocardial Infarction and Anemia : A Target Trial Emulation Using MINT Trial Data.

Gerard T Portela, Jeffrey L Carson, Sonja A Swanson, John H Alexander, Paul C Hébert, Shaun G Goodman, Philippe Gabriel Steg, Marnie Bertolet, Jordan B Strom, Dean A Fergusson and 11 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02981407 (Myocardial Ischemia and Transfusion), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02981407 phase3completednot on this map

Myocardial Ischemia and Transfusion

TypeinterventionalSponsorRutgers, The State University of New JerseyRan2017 to 2023Enrolled3,506ConditionsMyocardial Infarction, AnemiaArmsRed Blood Cell Transfusion
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Gerard T PortelaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (G.T.P., S.A.S.).ORCID 0000-0002-1871-6117
Jeffrey L CarsonDivision of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey (J.L.C.).ORCID 0000-0001-5466-2833
Sonja A SwansonDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (G.T.P., S.A.S.).
John H AlexanderDuke Clinical Research Institute, Duke University, Durham, North Carolina (J.H.A., R.D.L.).ORCID 0000-0002-1444-2462
Paul C HébertBruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada (P.C.H.).
Shaun G GoodmanSt. Michael's Hospital, Unity Health Toronto, and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada, and Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada (S.G.G.).ORCID 0000-0001-8068-2440
Philippe Gabriel StegUniversité Paris-Cité and French Alliance for Cardiovascular Trials (FACT), Paris, France (P.G.S.).
Marnie BertoletDepartment of Epidemiology and Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (M.B., M.M.B.).ORCID 0000-0002-5799-9033
Jordan B StromRichard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (J.B.S.).ORCID 0000-0002-6592-6141
Dean A FergussonOttawa Hospital Research Institute, Ottawa, Ontario, Canada (D.A.F.).ORCID 0000-0002-3389-2485
Tabassome SimonFrench Alliance for Cardiovascular Trials (FACT); Sorbonne Université; and Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pharmacologie, Plateforme de Recherche, Clinique de l'Est Parisien, Hospital Saint Antoine, Paris, France (T.S.).ORCID 0000-0002-4550-0450
Harvey D WhiteGreen Lane Clinical Coordinating Centre, Auckland, New Zealand (H.D.W.).ORCID 0000-0001-7712-6750
Howard A CooperDepartment of Cardiology, Westchester Medical Center, Valhalla, New York (H.A.C.).
J Dawn AbbottDivision of Cardiology, Warren Alpert Medical School, Brown University, Providence, Rhode Island (J.D.A.).ORCID 0000-0002-2560-0155
Sunil V RaoDepartment of Medicine, NYU Langone Health System, New York, New York (S.V.R.).
Bernard R ChaitmanDivision of Cardiology, St. Louis University School of Medicine, St. Louis, Missouri (B.R.C.).ORCID 0000-0002-9216-5317
Christopher B FordyceDivision of Cardiology, Vancouver General Hospital, and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada (C.B.F.).ORCID 0000-0002-4050-1518
Renato D LopesDuke Clinical Research Institute, Duke University, Durham, North Carolina (J.H.A., R.D.L.).ORCID 0000-0003-2999-4961
Benoit DaneaultUniversité de Sherbrooke, Sherbrooke, Quebec, Canada (B.D.).
Maria M BrooksDepartment of Epidemiology and Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania (M.B., M.M.B.).ORCID 0000-0002-2030-7873
MINT Investigators

Funding

Myocardial Ischemia and Transfusion (MINT) - CCCU01HL133817 · NHLBI · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI CARSON, JEFFREY LEE · 2016 to 2022
$17.1M
Myocardial Ischemia and Transfusion (MINT) - DCCU01HL132853 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BROOKS, MARIA MORI · 2016 to 2022
$4.1M
Chronic Renal Insufficiency and Silent Progression of Aortic Stenosis (CRISP-AS)R01HL169517 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Jordan Blair Strom · 2023 to 2026
$3.1M
A Novel Approach to Examine Within-Class Therapeutic Exchangeability of MedicationsR01AG063937 · NIA · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI GERHARD, TOBIAS · 2020 to 2024
$2.9M
Identification of the Components of Frailty Using Administrative Data and Metabolite ProfilingK23HL144907 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI STROM, JORDAN BLAIR · 2019 to 2023
$1.0M
NHLBI NIH HHS K23 HL144907NHLBI NIH HHS R01 HL169517NHLBI NIH HHS U01 HL132853NHLBI NIH HHS U01 HL133817NIA NIH HHS R01 AG063937
6 · The paper itself

Abstract

backgroundThe optimal hemoglobin threshold to guide red blood cell (RBC) transfusion for patients with acute myocardial infarction (MI) and anemia is uncertain.

objectiveTo estimate the efficacy of 4 individual hemoglobin thresholds (<10 g/dL [<100 g/L], <9 g/dL [<90 g/L], <8 g/dL [<80 g/L], and <7 g/dL [<70 g/L]) to guide transfusion in patients with acute MI and anemia.

designPrespecified secondary analysis of the MINT (Myocardial Ischemia and Transfusion) trial using target trial emulation methods. (ClinicalTrials.gov: NCT02981407).

setting144 clinical sites in 6 countries.

participants3492 MINT trial participants with acute MI and a hemoglobin level below 10 g/dL.

interventionFour transfusion strategies to maintain patients' hemoglobin concentrations at or above thresholds of 10, 9, 8, or 7 g/dL. Protocol exceptions were permitted for specified adverse clinical events. MEASUREMENTS: Data from the MINT trial were leveraged to emulate 4 transfusion strategies and estimate per protocol effects on the composite outcome of 30-day death or recurrent MI (death/MI) and 30-day death using inverse probability weighting.

resultsThe 30-day risk for death/MI was 14.8% (95% CI, 11.8% to 18.4%) for a <10-g/dL strategy, 15.1% (CI, 11.7% to 18.2%) for a <9-g/dL strategy, 15.9% (CI, 12.4% to 19.0%) for a <8-g/dL strategy, and 18.3% (CI, 14.6% to 22.0%) for a <7-g/dL strategy. Absolute risk differences and risk ratios relative to the <10-g/dL strategy for 30-day death/MI increased as thresholds decreased, although 95% CIs were wide. Findings were similar and imprecise for 30-day death. LIMITATION: Unmeasured confounding may have persisted despite adjustment.

conclusionThe 30-day risks for death/MI and death among patients with acute MI and anemia seem to increase progressively with lower hemoglobin concentration thresholds for transfusion. However, the imprecision around estimates from this target trial analysis precludes definitive conclusions about individual hemoglobin thresholds. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute.

Indexed as

AnemiaErythrocyte TransfusionHemoglobinsMyocardial InfarctionAgedFemaleHumansMaleMiddle AgedRecurrenceHemoglobins

Identifiers

PMID39348705
PMCPMC12701713

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.