Name:
Reality Trial
Description:
Reality Trial
Thumbnail URL:
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Duration:
T00H03M43S
Embed URL:
https://stream.cadmore.media/player/d15fa18e-a7aa-4472-be76-bcf51497836a
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/d15fa18e-a7aa-4472-be76-bcf51497836a/18778958.mp3?sv=2019-02-02&sr=c&sig=TbnLKl9WQpFcGKDee0f%2Bt4acy%2BI2yj9%2By1q18MO5xpg%3D&st=2024-05-06T09%3A15%3A29Z&se=2024-05-06T11%3A20%3A29Z&sp=r
Upload Date:
2022-02-28T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
>> Practice Impact Extra podcasts are derived from Hurst's, The Heart Board Review, and other online resources available only through accesscardiology.com. [ Music ] >> We all realize that blood is a valuable and limited resource. The guidance of its use really surrounds the risk and benefit. And I think that's a symptom to recognize those. [ Music ] Hi, Dr. Bernie here, and welcome to Practice Impact Extra.
A previous trial published in August of 2018 assessed the efficacy of the restricted blood transfusion strategy to a more liberal one among moderate to high-risk patients undergoing cardiac surgery. Restricted transfusion to a hemoglobin less than 7.5 and a liberal transfusion for hemoglobin less than 9.5. The results of this trial of nearly 5,000 patients indicated that a restricted red cell transfusion strategy was non-inferior to the liberal strategy and may not always be beneficial, particularly in the elderly.
At the recent European Society of Cardiology meetings in September 2020, the REALITY Trial was presented. This is a randomized trial of transfusion strategy in patients with myocardial infarction and anemia. The goal was to assess the safety and efficacy of a restricted versus a liberal red cell transfusion strategy among patients with acute MI and anemia.
They enrolled 668 patients and followed them for 30 days. Inclusion criteria including acute MI, either non or -- non-STEMI or STEMI with an anemia with the hemoglobin less than 8 to less than 10 grams per deciliter. Patients were randomized to a liberal strategy if hemoglobin dropped to less than 10 or to a restricted transfusion strategy for hemoglobins that were less than 8.
So what was the primary outcome? The primary outcome all-cause death, reinfarction, stroke and ischemia that prompted revascularization was restricted. And liberal transfusion was significant for non-inferiority. It was not determined that it was superior, however. Regarding safety, the restricted transfused group was less likely to develop infection or acute lung injury.
So what's my take? The REALITY Trial, I believe, is an important trial that supports the restrictive transfusion strategy in myocardial infarction patients with anemia. I'm looking forward to the results of a larger worldwide NIH-supported trial, MINT, M-I-N-T, myocardial infarction and transfusion, which is testing the superiority of restricted versus liberal transfusion strategy. Hopefully, the result will influence transfusion practice.
So stay tuned. Thanks for joining me and see you next time on Practice Impact Extra. >> We hope you enjoyed this podcast from McGraw-Hill. Subscribers to AccessCardiology have instant access to over 25,000 pages of rich medical content, receive medical updates from trusted experts, and have access to other special features. To subscribe or learn more, please visit accesscardiology.com.