6/29/23, 1:08 AM REALITY Pathway Feedback Search Clinical Topics Home Studies REALITY REALITY Disease Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Transfusio Trial question Is a restrictive blood transfusion strategy noninferior to a liberal blood transfusion strategy in patients with acute myocardial infarction and anemia? Study design Multi-center Open label RCT Population Characteristics of study participants 42.0% female N = 666 58.0% male 666 patients (281 female, 385 male) Inclusion criteria: adult patients with myocardial infarction and anemia Key exclusion criteria: shock; myocardial infarction occurring after PCI or CABG; life-threatening or massive ongoing bleeding; blood transfusion in the past 30 days; and malignant hematologic disease Interventions N=342 a restrictive strategy (transfusion triggered by Hgb 8 g/dL) N=324 a liberal strategy (transfusion triggered by Hgb 10 g/dL) Primary outcome https://web.pathway.md/studies/recr0FOQ9vEASH2Lk 1/2 6/29/23, 1:08 AM REALITY Pathway Composite outcome of death, stroke, recurrent myocardial infarction, or emergency revascularization prompted by ischemia at 30 days 14.0 % 14 11 10.5 % 7.0 % Difference not exceeding nonferiority margin 3.5 % 0.0 % A restrictive strategy A liberal strategy Difference not exceeding nonferiority margin in composite outcome of death, stroke, recurrent myocardial infarction, or emergency revascularization prompted by ischemia at 30 days (11% vs. 14%; ARD -3, 95% CI -8.4 to 2.4) Safety outcomes No significant difference in adverse events. Conclusion In adult patients with myocardial infarction and anemia, a restrictive strategy was noninferior to a liberal strategy with respect to the composite outcome of death, stroke, recurrent myocardial infarction, or emergency revascularization prompted by ischemia at 30 days. Reference Gregory Ducrocq, Jose R Gonzalez-Juanatey, Etienne Puymirat et al. Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial. JAMA. 2021 Feb 9;325(6):552-560. Open reference URL https://web.pathway.md/studies/recr0FOQ9vEASH2Lk 2/2