AM24-ST-10-O: Debate: Liberal versus Restrictive Transfusion Strategy in Acute Myocardial Infarction (AABB/ISBT Joint Session) (Enduring)

The Myocardial and Ischemia Trial (MINT) was published in December 2023. MINT enrolled 3504 patients with acute myocardial infarction and hemoglobin concentration less than 10 g/dL and randomly allocated participants to either a liberal transfusion strategy that required transfusion to maintain hemoglobin concentration greater than or equal 10 g/dL or a restrictive transfusion strategy that permitted transfusion below 8 g/dL and strongly recommended transfusion below 7 g/dL. The investigators concluded “In patients with acute myocardial infarction and anemia, a liberal transfusion strategy did not significantly reduce the risk of recurrent myocardial infarction or death at 30 days. However, potential harms of a restrictive transfusion strategy cannot be excluded.” The clinical implications of this large study continue to be discussed. In addition, this trial data is now being incorporated into meta-analyses together with other trials conducted in the setting of acute myocardial infarction and anemia. Following the successful format of a debate at the 2023 AABB meeting, two speakers will now debate whether anemic patients with acute myocardial infarction should be managed with a liberal or restrictive transfusion strategy, and provide arguments for and against each approach.