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Anemia Acuity Effect on Transfusion Strategies in Acute Myocardial Infarction
François Martin Carrier, Howard A. Cooper, Gerard Portela, Marnie Bertolet, Gilles Lemesle, Micah T. Prochaska, Sarang Kim, John H. Alexander, Ian Crozier, Grégory Ducrocq, Alexandre Schaan de Quadros, Akshay Bagai, Marianna Deway Andrade Dracoulakis, Mina Madan, Maria M. Brooks, Jeffrey L. Carson, Paul C. Hébert, Fei Chen, Patrick Desanto, Karen Dragert, William J. Kostis, Deborah McCloskey, Helaine Noveck, Sheila Redding, Ami Patel, Shahab Ghafghazi, Sharon Vincent, Hardeep Dholiya, Dinesh Kalra, Jennifer A. Moore, Mallory Hatfield, Syed Haidry, Ahmed Hassanin, Risheek Kaul, Fnu Namrata, Parija Sharedalal, Jayakumar Sreenivasan, Jasjit Bhinder, Mohammed Hasan Khan, Anna Koulova, Behram Mody, Yogita Rochlani, Anuritha Tirumani, Frances O. Wood, Rhonda Norton, LaMonica Daniel, Mark Menegus, Samanta Baboolall, Sheila Davila, Noelle Manning, Mollie Machado, Judah Rauch, Angeline Camilo, Estefanía Hernández, Muhammad Iqbal, Ervin Mazniku, O Ramírez, Veronica Day, Barry F. Uretsky, Jesse Byrd, Kristin Miller, Srikanth Vallurupalli, Gregory Maniatis, Richard Dima, Roman Royzman, Sean Taylor, Amanda Tice, Brandon Dilluvio, Luis Gruberg, Puneet Gandotra, Rachel Gentles, Barbara Shannon, Maria Masih, Robert O. Roswell, Alana Gulliver, Meriton Ruhani, Emily Strober, Samia Tamazi, Adam Gershon, Kristie Coleman, Bernard Kadosh, Rajiv Jauhar, Harsha Adnani, Kyle Agostini, Loukas Boutis, Ian Dalangin, Barry H. Kaplan, Jae Sung Lee, Perwaiz Meraj, Riona Timmons, Carl D. Reimers, Craig Basman, Umar Rashid, A. Garvey Rene, Asha Mellor, Karen duBourg, Joseph S. Rossi, Ryan Orgel, Emma Reynolds, Tatum Scholl, Janet R. Bogan, Olivia Bogdan, Matt Cavender, Gaetana Cosentino, Gabriela De Jesus, Megan Gonzalez, Julia Hoang, Emma Kleemann, Deanna Ravenscraft, Teresa L. Reed, Joshua Roark, Samantha Smith, Kaitlyn Sternat, Oreyane Tate, Tyrone Wade, Hope Wolf, Farhad Abtahian, Megan Littleton, Kayla Malchoff, Kelly Mohr, Emily Pierce, Jennifer LaLonde, Kellie Sherron, Tia Albro, Patty Noll, Meechai Tessalee, Claudia Eaton, Gregory W. Barsness, Diana Albers, Jacob C. Jentzer, J. Dawn Abbott, Kelly Franchetti, Catherine Gordon, Herbert D. Aronow, Ellen Cerullo, Lori-Ann Desimone, Elizabeth C. Nowak, Elizabeth Coccio, Kodangudi B. Ramanathan, Adedayo Adeboye, Ashley Armstrong, Lillie Johnson, Anh-Phuong Pham, Rahman Shah, Mark Schmidhofer, M. J. ALBRIGHT, Melissa Enlow, Barinder Hansra, Tracy L. Nicholson, Catalin Toma, Darrell J. Triulzi, Megan Basch, Amanda Bollino, Laurie Dennis, Kathy S. Puntil, Chelsey Snyder, Linda Spearman, Jenny Whitehead, Friederike K. Keating, Bhisham Harchandani, Meghan Sesera, Jonathan Halevy, Molly Raftery, Marilynn Roth, David S. Kountz, Michael Carson, Lynda Argenzio, Michael C. Kontos, Melissa Sears, Laura Johnson, Mansoor Qureshi, Ahmad Mizyed, Sarah Whitsett, Kristina Wippler, Jay S. Raval, Stacey Clegg, Warren K. Laskey, Judith Mondragon, Tamar S. Polonsky, Matthew L. Carlson, Catherine Drovetsky, Joseph Gutbrod, Maud H.E. Jansen, Tharani Jeyaram, Noora Reffat, Rajesh Gupta, Mujeeb Sheikh, Meghan Moore, Kristin Fischer, Jennifer Gilmore, Christina Sattler, Stephanie Frank, Lynne Uhl, Kalon K.L. Ho, Hannah Hunsaker, Jenifer Kaufman, Lauren Lanuto, Jordan B. Strom, Patricia Tyler, Paul Mullen, Jennifer M. Ratcliffe, Brandy Williams, Arthur Bracey, Araceli Boan, Gilberto De Freitas, Samantha Macias, George Younis, William Matthai, Sameer Khandhar, Karen Maslowski, Nilay Patel, Sammy Elmariah, Christopher P. Stowell, David M. 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Reedy, Andrea Sarafolean, Eric McCamant, Jason Scott, Michelle Jordan, Kay Knepper, Jennifer Nguyen, Deborah Ramsey, Tara Tawil, Todd Wood, Dhvni Dave, Heidi Testa, Rajesh V. Swaminathan, Sunil V. Rao, Kathy Aristy, Mitchell W. Krucoff, Thomas J. Povsic, Andrew M. Goldsweig, Shahbaz A. Malik, Yiannis S. Chatzizisis, John V. Higgins, Poonam Velagapudi, Dávid Barton, Jeremy Stone, Samer Sayyed, Arav Jhand, Daniel Johnson, James Sullivan, Furquan Khattak, Kara Stout, Jennifer Nickol, David S. Shin, Mansi Oberoi, Taylor Johnson, Melissa D. Howard, Zaria Starfeldt, Ryan Ruskamp, Nathan Muhn, C. Pacheco, Tyler Patterson, Angie Adler, Andrew P. DeFilippis, Kárita Cláudia Freitas Lidani, Cassandra Reynolds, Nicholas Brooks, Stephan Bierenga, Adam C. Salisbury, Jamie Hall, David Landers, Robert C. Hendel, Wilson Ginete, Ganesh Raveendran, Craig Hudak, Ramin Ebrahimi, Richard G. Bach, Margie Palazzolo, Kimberly Striler, Paolo Mascari, Hal S. Wasserman, Joseph M. Delehanty, Raj C. 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Yamamoto, Dalton Bertolim Précoma, Cristina Correa, Maynara Martins, Carlos Rochitti, Camila Richter, Carlos Alberto Kenji Nakashima, Eliane Sehnem, Frederico Toledo Campo Dall’Orto, Gislayne Rogante Ribeiro, Ricardo Reinaldo Bergo, Claire Marie Pedroso Dias Corsini, Kemilys Marine Ferreira, Pedro Beraldo de Andrade, Róbson Alves Barbosa, Natalia Alvaia, Rodolfo Dourado, Jéssica Ribeiro, Camilla de Oliveira Vieira, Aline Giacomo, Mariana Lopes, Lília Nigro Maia, Osana Costa, Paulo Jhones Dutra, Danieli Frassatto, Maria Angélica Lemos, Thaise Loverdi, Marcelo Arruda Nakazone, Nadielly Prado, Osvaldo Da Silva Júnior, Natalia Cordeiro da Silva, Sidney Gomes, Anna Helena Felipe Pereira Centurione, Luiz Eduardo Fontelles Ritt, Queila Borges de Oliveira, Karina De Carvalho Cordeiro, Alexandre Schaan de Quadros, Giulia Bonatto, Bruna Machado, Silvia Poleth, Camille A. Correia, Raphael Boesche Guimarães, Israel Cabral, Dário Celestino Sobral Filho, Maria Cleide Freire Clementino da Silva, O Carvalho, José Gildo de Moura Monteiro Júnior, Sergio Nascimento, Fernando De Martino, Paula Miranda Camasmie, Leonilda Castanho Da Rocha, Pâmela Assunção, Fábio Rodrigues de Oliveira, Paulo Henrique Maia Vilela, Rodrigo Cunha de Sousa, Estêvão Lanna Figueiredo, Fernando Carvalho Neuenschwander, Cristina Carvalho Neuenschwander, Izabela Rodarte Falco, Arlete Matos, Thao Huynh, N Sánchez Fuentes, Amanda Barnett, C. Boudreault, Greg Schnell, Leslie Poirier, Darlene Ramadan, Manohara Senaratne, Bernadette Fernando, Mike Hanninen, Anushka Jayasekara, Janek Senaratne, Lalantha Coonghe, Sharada Manchikanti, Gamintha Nanayakkara, Vikas Tandon, Patricia Power, Ryan Proc, Kajenny Srivaratharajah, Lisa Trombetta, Pablo Mendoza, Krysten Gregus, Jacqueline Hare, Kelly Lawrence, Ameen Patel, Shirley Pettit, Jocelyn Kuber, Summer Nasr, John Neary, Muammar Abdulrahman, David Cohen, Yola El Dahr, Faraaz Quraishi, Laura Tomat, Spencer Wikkerink, David Laflamme, Miriam Schnorr Meloche, Christel Simard, Lise Blais, Jean‐Pierre Déry, Christina Avena-Cyr, Mélanie Roy, Micheline Charron, Kevin R. Bainey, Norma Hogg, Suzanne Welshsan, Richard Haichin, Coralie Gasc, Reza Sahebjamei, Fatemeh Vaezi-Poor, Payam Dehghani, Sabiha Sultana, Ata ur Rehman Quraishi, Hussein Beydoun, David Fillmore, Deborah S. Keller, Nick Bartlett, Brian J. Potter, Fatna Benettaib, Adriana Carbonaro, Isabelle Chausse, Katherine Coutu-Beaudry, Maya Hatwik, Martine Lebrasseur, Cindy Prié, Caroline Vallières, Dounia Boumahni, Genevieve Dallaire, Renée Duclos, Ali Ghamraoui, Mélissa Gagnon-Hamelin, Emilie Sau, Michael Goldfarb, G Ricafort, Claudine Robert, Sophie Florencio, Christopher B. Fordyce, Jackie Chow, Reilly Ische, Ngaire Meadows, Andrew Starovoytov, Sydney Thorsteinsson, Naomi Uchida, Lily Cai, Shirley Geok‐lin Lim, Jenny Petterson, Himantha De Silva, Stella Chan, Celine Yan, Ying Tung Sia, Miguel Barrero, Ricardo Costa, Ariel Diaz, Martin Faucher, Carl-Éric Gagné, Jean-François Naud, Philippe Rheault, Yanek Pépin‐Dubois, Vincent Spagnoli, Isabelle Roy, Benoit Daneault, Julie Caron, Sara Jabeen, Nidhya Lakshmi Thulasiraj, N. Alvarez Garcia, Suneet Khurana, Terry McPherson, Rehana Bajwa, Cassie Wagner, John Ducas, Kunal Minhas, Kiran Atwal, Malek Kass, Stephen Allan Schaffer, N. Brass, Rebecca Cairns, Anna S. Law, Mona Doorsian, Neil Fam, Jan O. Friedrich, Andrew Baker, John Graham, Michael Kutryk, Gyan Sandhu, Imrana Khalid, Marlene Santos, Simon Robinson, Kim M. Allen, Noreen Lounsbury, Sheryll Sorensen, Elizabeth C. Martin, Vladimír Džavík, Anna Tran, Razi Khan, Nicolas Michaud, Philippe Gabríel Steg, Arthur Darmon, Quentin Fischer, Neila Sayah, Hélène Abergel, Catherine Bouffard, Audrey Cailliau, Axelle Fuentes, Nicolas Pham, Alexandre Gautier, Jules Mesnier, Étienne Puymirat, Mélissa Sriwaran, Rachel Elysee, Antoine Fayol, Amandine Grelier, Nesrine Hafsi, Hasina Rakotosamimanana, Victoria Tea, Sarah Arab, Hinde Irekti, Anne Druart, Isabelle Pilat, Basile Verdier, Émile Ferrari, E Fourrier, Mohamed Labbaoui, Nassim Redjimi, Amina Zamiti-Smondel, Rabab Bencherif, Benoît Lattuca, Elodie Delelo, Johanne Silvain, Olivier Barthélémy, Fatima Benattia, Perrine Devos, Soraya Merbah, Juliane Posson, Nikki Procopi, Thomas Wallet, Michel Zeitouni, Arnaud Ferrante, Camille Granger, Stéphane Manzo‐Silberman, Tomy Salloum, Gérald Vanzetto, G. Barone Rochette, Sara Blanc Vannet, Clémence Charlon, Océane Crebier, Stéphanie Marlière, Pauline Peretout, Julie Hildt, Laura Cetran, Thomas Baudinet, Pierre Coste, Amandine Ruissel, Marine Servat, Thibault Lhermusier, Frédéric Bouisset, Francisco Campelo-Parada, Kimberly Lemoine, Mouin Nasr, Marine Poisay, Clément Servoz, Stéphanie Tribeau, Yves Cottin, F. Bichât, M. Saint-Jalmes, Victor Buzura, Yann Rosamel, Sarah Hadjih, Denis Angoulvant, Emilie Collet, Fabrice Ivanes, Katia Lassouani, Mohammed Mouzouri, Djedjiga Naudin, Thibaud Genet, Jean Guillaume Dillinger, Nadhira Bennacer, Lea Cacoub, Antoine Léquipar, Baya Mahtout, Christophe Thuaire, Marina Leniliot, Emilie Tachot, Corine Thobois, Christel Vassaliere, Batric Popovic, Jessica Breistroff, Aurélie Gutehrle, Maximilien Saint-Gilles, Jeanne Varlot, Éric Durand, Delphine Béziau-Gasnier, Najime Bouhzam, Solenn Catherine, Bryan Marais, Christophe Tron, Claire Vézier, Thibaut Hemery, Claire Bouleti, Arthur Ramonatxo, Sonia Azzakani, Nathalie Berger, Céline Boucher, François Roubille, Chloé Bonneton, Gautier Desmoulin, Fabien Huet, Sandra Kahlouche, Laurent Delorme, Angélique Andrieu, Javier Molina-Martín de Nicolás, Nathalie Durand, Marion Berous, Romain André, John Elliott, C. Cruickshank, Houda El Banna, Michael Hume, Jocelyne Benatar, J. Somaratne, Diana Gatland, Danica Kistanna, Cathrine Patten, Doreen Singh, Samraj Nandra, Chuen Siang Low, Susan Vallancey, Ian Ternouth, Neelam Dalman, Aleisha Easton, Carolyn Jackson, Simon Kirkham, Nick Fisher, Jette Koelle, Charlotte McNab, David Brieger, Shahab Pathan, Imants Rubenis, S. Swe, Sohaib Virk, Graham S. Hillis, Michelle M. Bonner, Charmaine Dias, L. David Hillis, Shaun G. Goodman, Renato D. Lópes, Tabassome Simon, Harvey White, Caroline Alsweiler, Bernard Chaitman, Dean Fergusson, Erin Morton, Lilian Mazza Barbosa, Pedro Gabriel Melo de Barros e Silva, Liliane A.T. Arnaldi Seixas, Paola Engelmann Arantes, Larissa Teixeira Aleixo Silva, Georgia Beatriz Oliveira Damásio, Laurence Bérard, Alexandra Rousseau, Sandra Paco, Narimane Benhamadi, Véléda Blesboi, Marie Delon, Alexia Ep, Kaïna Mahmoudi, Katia Ledra, Irène Garcia Ramos, Marie Henault, Alexia Dantigny, A. Kone, Djouher Firoud, Véronique Pignot, Élodie Drouet, Eunice Nubret, Margot Bobin, Christophe Aucan, Lauren Demerville, Serge Bureau, Maria Pina Simula, Derek P. Chew, Yogesh Sharma, C. Hincks, Ivana Hunt, Simeoni Thomas, Fiona Wollaston, Brandon M. Herbert, M. Lombardero, R. Mercurio, Jennifer C. Stevenson, Donna Stoliker, Ella Zadorozny, Jane Eckstein, Simone A. Glynn, Eric Leifer, Erin N. Smith, George Sopko, Phil Tonkins, Pablo Cure, Catherine Levy, Naomi L.C. Luban, Barbara A. Konkle, Deepak Bhatt, Eldad A. Hod, Cassandra D. Josephson, KyungMann Kim, Agnes Lee, Leslie Serchuck, Peter Stone, Darby Thompson, Kathryn L. Weise
Bibliographic record
VenueJAMA Network Open · 2024
Typearticle
Languageen
FieldMedicine
TopicErythropoietin and Anemia Treatment
Canadian institutionsHealth Sciences CentreSunnybrook Health Science CentreUniversity of TorontoSt. Michael's HospitalUniversité de MontréalCentre Hospitalier de l’Université de Montréal
FundersNational Heart, Lung, and Blood InstituteInstitute of Circulatory and Respiratory HealthCanadian Institutes of Health ResearchAgence Nationale de la RechercheCanadian Blood Services
KeywordsMedicineAnemiaRandomizationMyocardial infarctionRandomized controlled trialInternal medicinePediatrics
Abstract
Importance: In patients with acute myocardial infarction (MI), limited physiologic adaptation to acute anemia might lead to greater benefit from a liberal red blood cell (RBC) transfusion strategy. Data on such a possible benefit are lacking. Objectives: To compare acute anemia with chronic anemia and post-MI outcomes and estimate the differential effect of a restrictive RBC transfusion strategy compared with a liberal strategy on post-MI outcomes according to anemia acuity. Design, Setting, and Participants: A prespecified subgroup analysis of the Myocardial Ischemia and Transfusion (MINT) multicenter randomized clinical trial was conducted in 126 hospitals in 6 countries between April 26, 2017, and April 14, 2023, with 30-day follow-up and blinded adjudication of the primary outcome. The analysis included 3144 of 3504 MINT participants (89.7%) with acute MI, a hemoglobin (Hb) level less than 10 g/dL at randomization, and a first Hb measurement available on the day of or the day following hospital admission. Intervention: The MINT trial randomized participants to a restrictive (Hb <7-8 g/dL) or liberal (Hb <10 g/dL) RBC transfusion strategy. Acute anemia was defined as having a first Hb value greater than 13 g/dL (men) or 12 g/dL (women), or as having a decrease greater than or equal to 2 g/dL between the first Hb measurement and measurement at randomization. Other Hb levels were categorized as chronic anemia. Main Outcomes and Measures: The primary outcome was a composite of death or recurrent MI up to 30 days after randomization. Secondary outcomes were death, recurrent MI, cardiac death, heart failure, pulmonary complications, and major bleeding events. Intention-to-treat analysis was performed. Results: Among 3144 included participants (mean [SD] age, 72.3 [11.6] years; 1715 [54.5%] male; 1307 [41.6%] with type 1 MI), 1078 [34.3%]) had acute anemia. Acute anemia was associated with an increased risk of death or recurrent MI (adjusted risk ratio, 1.25; 95% CI, 1.05-1.48). The effect of a restrictive RBC transfusion strategy compared with a liberal strategy was similar for participants with either acute or chronic anemia for all outcomes. Conclusions and Relevance: In this secondary analysis of the MINT trial, acute anemia was associated with less favorable post-MI outcomes than chronic anemia but did not modify the effects of the randomized transfusion strategy. In patients with anemia and MI, the acuity of anemia should not influence the choice of transfusion trigger. Trial Registration: ClinicalTrials.gov Identifier: NCT02981407.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.737
Threshold uncertainty score0.591
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
Opus teacher head0.013
GPT teacher head0.313
Teacher spread0.300 · how far apart the two teachers sit on this one work
Validation status
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".
Quick stats
Citations6
Published2024
Admission routes2
Has abstractyes