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Blood transfusion research set to change the course of practice for heart attack treatment


OTTAWA, November 11, 2023 – Counter to widely adopted blood transfusion strategies in acute care settings, patients with acute myocardial infarction (MI), commonly known as a heart attack, may need a different transfusion strategy, according to new research.

The study, published today in the New England Journal of Medicine, is the result of a multinational trial involving 3,506 participants comparing red blood cell transfusion strategies for patients who had a heart attack and were anemic. While using a restrictive transfusion strategy has been widely adopted in most acute care settings, study findings indicate that patients suffering from heart attack may benefit from a liberal transfusion strategy instead.

Restrictive strategies limit the amount of blood given simply by transfusion at a lower hemoglobin concentration (70 g/L) than liberal strategies, which aim to maintain a concentration higher than 100 g/L.

“Decades worth of research has shown that, for the most part, restrictive strategies decrease blood transfusion by half while not affecting outcomes like mortality within 30 days from transfusion,” said Dr. Paul Hébert, Senior Investigator at the Bruyère Research Institute and Scientist at CHUM Research Centre, referencing the landmark Canadian study that changed blood transfusion practices in critical care worldwide. “Despite this, patients with heart attacks have always been a unique concern. From this study, the evidence is showing us we do need to take special care when treating this population.”

“The results of the MINT trial indicate that a liberal strategy of blood transfusion may improve outcomes in anemic patients with heart attacks without causing undue harm,” said Dr. Jeffrey L. Carson, Distinguished Professor of Medicine at Rutgers Robert Wood Johnson Medical School and the lead investigator of the trial.

Though the current study did not prove definitively that more blood is better, all trends in the data suggest that patients do worse with a restrictive approach to transfusion. This is the first study to date demonstrating harms for patients during blood transfusion in any acute care setting and indicates that patients with a heart attack who are also anemic should get more blood not less because it is likely safer.

“This study’s robust design conducted across multiple countries provides the much-needed evidence to guide clinicians when treating acute myocardial infarction patients with anemia,” said Dean Fergusson, PhD, Senior Scientist and Deputy Scientific Director for Clinical Research at The Ottawa Hospital and Professor at the University of Ottawa.

Restrictive or Liberal Blood Transfusion in Patients with Myocardial Infarction and Anemia was published today in the New England Journal of Medicine.


Bruyère is an academic health care organization training the next generation of health care leaders and using research and industry partnerships to improve care. Bruyère plays a unique role in the region’s health care system providing specialized hospital care, primary care, long-term care, and assisted and independent living for older adults while the Bruyère Research Institute focuses on finding the next generation of care for aging Canadians and vulnerable populations. To learn more about Bruyère, visit www.bruyere.org.

As one of the America's leading comprehensive medical schools, Robert Wood Johnson Medical School is dedicated to the pursuit of excellence in education, research, health care delivery, and the promotion of community health. It is one of eight schools that comprise Rutgers Health, the clinical arm of Rutgers, The State University of New Jersey, which is ranked 15th in the U.S. News and World Report 2024 Best Colleges rankings.

The Ottawa Hospital (TOH) is one of Canada’s top learning and research hospitals where we are guided by our vision to provide the world-class and compassionate care we would all want for our loved ones. Our multi-campus hospital, affiliated with the University of Ottawa, is home to the Regional Trauma Centre and Cancer Centre, and to discoveries that are adopted globally. Backed by generous support from the community, we are focused on reshaping the future of health care to improve the health of our diverse population of patients from Eastern Ontario, Western Quebec, and Nunavut. For more information about The Ottawa Hospital, visit OttawaHospital.on.ca.

Media Contact:
Jasmine Rooke
Research Communications Manager
Bruyère Research Institute



This research was funded in North America by the National Heart, Lung, and Blood Institute (NHLBI), and Canadian Institutes of Health Research (CIHR) Institute of Circulatory and Respiratory Health.