Search Results for: Anemia sideropenica e carenza marziale senza anemia: senza ferro si sta male

Circulation, Volume 150, Issue Suppl_1, Page A4144552-A4144552, November 12, 2024. Background:Heart Failure(HF) significantly deteriorates outcomes in patients with Atrial Fibrillation. Heart Failure with Preserved Ejection Fraction(HFpEF) and Atrial Fibrillation(AFib) share common disease progression pathways and are gradually increasing in prevalence.Aim:We aim to study the variation in characteristics and outcomes based on type of heart failure in patients with AFib using the National Readmission Database(2016-2020).Methods:NRD database was used to identify patients with Atrial Fibrillation using ICD-10 codes. Patients were stratified into two groups based on the presence of systolic dysfunction and diastolic dysfunction. Patients with combined systolic and diastolic dysfunction were excluded. Information was collected on patient demographics, comorbidities, and outcomes. Propensity score matching was performed to compare outcomes among AFib patients with HFrEF and HFpEF.Results:A total of 6,673,080 patients with AFib and isolated systolic or isolated diastolic dysfunction were included in the analysis. 3,914,695(58.66%) had HFpEF and 2,758,385 (41.34%%) had HFrEF. In the HFpEF group 57.8% were females in comparison with 33.12% females in the HFrEF group. HFpEF group had a higher rate of hypertension (84.9% vs 82%, p

Circulation, Volume 150, Issue Suppl_1, Page A4144512-A4144512, November 12, 2024. Introduction:Transcatheter edge-to-edge repair of the mitral valve with the MitraClip has offered a less invasive percutaneous alternative to surgical repair in select candidates with mitral regurgitation. Various factors impact the outcomes of MitraClip. We investigated the impact of nutritional status on the outcomes of MitraClip.Methods:Utilizing the nationwide inpatient sample data for years from January 1, 2016, and December 31, 2021, patients who underwent MitraClip were identified. They were categorized based on obesity and protein energy malnutrition (PEM). Statistical significance was assigned at p

Circulation, Volume 150, Issue Suppl_1, Page A4139144-A4139144, November 12, 2024. Background:Iron deficiency anemia (IDA) affects approximately one-third of patients with systolic heart failure, yet comprehensive population-based analyses of its impact on in-hospital outcomes remain limited. This study seeks to examine how IDA influences in-hospital outcomes among individuals with decompensated systolic congestive heart failure (HFrEF).Methods:Using data from the National Inpatient Sample (NIS) database spanning from 2017 to 2021, this study identified patients hospitalized for decompensated systolic congestive heart failure (HFrEF) with a secondary diagnosis of IDA using ICD-10 codes such as I5020-23 and D500, D501, D508, D509. Propensity score matching (PSM) was then employed to create cohorts without and with IDA at a 1:3 ratio. Multivariate regression analyses were conducted to evaluate various outcomes, including in-hospital mortality, cardiogenic shock (CS), acute myocardial injury (AMI), cardiac arrest, ventricular tachycardia (VT), ventricular fibrillation (VF), length of stay (LOS), and total hospitalization charges. Furthermore, the utilization rate of mechanical ventilation and circulatory support, including intra-aortic balloon pump and extracorporeal membrane oxygenation, was evaluated in both cohorts.Results:Among 253,034 HFrEF hospitalizations, 16,200 (6.4%) had a secondary diagnosis of IDA. After PSM, multivariate regression analyses revealed no significant differences in the odds of cardiogenic shock (10% vs. 10%, p=0.86), in-hospital mortality (2.6% vs. 2.8%, p=0.71), and LOS (7.19 vs. 7.27 days) between the two groups. Additionally, the likelihood of cardiac arrest, ventricular arrhythmias, AMI, and utilization of mechanical ventilation and circulatory support did not reach statistical significance. However, patients with IDA and HFrEF had higher hospitalization charges ($85,516 vs. $93,000).Conclusion:HFrEF patients, with or without IDA, had similar odds of cardiogenic shock, in-hospital mortality, mechanical circulatory support utilization, as well as LOS. However, IDA with HFrEF correlated with higher hospitalization charges.

Circulation, Volume 150, Issue Suppl_1, Page A4143356-A4143356, November 12, 2024. Background:Currently, there are no validated tools to stratify bleeding risk in cancer patients undergoing percutaneous coronary intervention (PCI). The presence of cancer itself is considered a major high bleeding risk (HBR) feature according to the Academic Research Consortium (ARC) definition. However, cancer creates a hypercoagulable state and predisposes patients to thrombotic complications as well as bleeding.Hypothesis:A dedicated HBR definition for cancer patients undergoing PCI could be useful to identify subjects at higher risk of adverse events.Aims:To validate an adapted version of the ARC-HBR criteria in patients with cancer undergoing PCI.Methods:Consecutive patients with a history of cancer undergoing PCI between 2012 and 2022 at a tertiary care center (Mount Sinai Hospital, New York, US) were included. According to our adapted definition, patients were considered at HBR if they met at least one of the major ARC-HBR criteria (other than cancer) or two minor criteria.The primary endpoint was a composite of periprocedural in-hospital or post-discharge bleeding at 1 year. The key secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE) consisting of death, myocardial infarction, or stroke.Results:Of the 2,007 cancer patients included in this study, 1,142 (56.9%) were classified as HBR. Moderate to severe anemia was the most prevalent major HBR criterion (Figure 1).At 1 year, the incidence of bleeding was significantly higher in HBR compared to non-HBR patients (10.9% vs. 3.9%, adj. HR: 2.10, 95% CI: 1.39-3.18, p

Circulation, Volume 150, Issue Suppl_1, Page A4148106-A4148106, November 12, 2024. Background:Hemophilia is a rare X-linked recessive inherited bleeding disorder. Owing to improved management, the life expectancy of patients with hemophilia has increased significantly and predisposes them to risk of cardiovascular diseases and thrombotic events. However, studies on cardiovascular risk factors and outcomes in patients with hemophilia are limited.Aims:Therefore, the present study aimed to examine the prevalence of cardiovascular disease, the risk factors, and the outcomes in patients with hemophilia.Methods:The study identified all adult males with a primary and secondary diagnosis of hemophilia in the National Inpatient Sample (NIS) database from 2018 – 2020. The overall study population was compared to the general population, non-hemophilia. The primary outcome was to estimate the prevalence of cardiovascular risk factors in patients with hemophilia compared to the general population. The secondary outcomes comprise the odds of adverse events, including myocardial infarction, ischemic stroke, transient ischemic attack (TIA), occlusive atherosclerotic disease, percutaneous coronary intervention, and coronary artery bypass graft (CABG)., We conducted a multivariate logistic regression to estimate the odds of the outcomesResults:Out of the total 7,377,811 adult male study population, 11,291 (0.2%) had hemophilia, and 7,377,811 (99.8%) with non-hemophilia. The hemophilia cohort was slightly older (63.2[16.8] vs. 61.5[17.4]) and was also more likely to have diabetes mellitus, hyperlipidemia, chronic lung disease, chronic kidney disease, chronic liver disease, BMI ≥ 25, anemia, metastatic cancer, and atrial fibrillation. In the adjusted models, patients with hemophilia had higher odds of myocardial infarction (OR 2.62, 95% CI: 2.47 – 2.77), ischemic stroke (OR 2.71, 95% CI: 2.53 – 2.89), TIA (OR 10.44, 95% CI: 9.40 – 11.60), occlusive atherosclerotic disease (OR 2.31, 95% CI: 2.08 – 2.56), PCI (OR 5.31, 95% CI: 4.86 – 5.80), and CABG (OR 7.62, 95% CI: 6.97 – 8.33).Conclusions:Our study found that patients with hemophilia had a higher prevalence of cardiovascular risk factors and adverse events compared to males without hemophilia in the United States. Further research is to identify potential ex-specific risk factors that predispose to worse cardiovascular outcomes among patients with hemophilia.

Circulation, Volume 150, Issue Suppl_1, Page A4145118-A4145118, November 12, 2024. Background:Obstructive Sleep Apnea (OSA) is the most common sleep related disorder and shares common pathophysiological mechanisms with Peripheral Arterial Disease (PAD). Studies exploring the influence of OSA on PAD have largely focused on subclinical markers of PAD such as ankle brachial indices and pulse wave velocities. We sought to investigate the association of OSA with Major Adverse Limb Events (MALE) in patients with PAD.Methods:National Inpatient Sample 2018-2020 was utilized for this analysis. MALE was the primary outcome, defined as a composite of Acute Limb Ischemia, Limb Revascularization (either percutaneous or surgical), limb amputation and All-Cause mortality. ICD-10 codes were utilized to identify the diagnoses of choice. Propensity score matching was performed between the 2 groups of OSA and no OSA using the caliper match method for the variables, Age, Gender, Stroke, Obesity, Hypertension, Anemia, Coagulopathy, ESRD, Diabetes, Chronic Pulmonary Disease, Congestive Heart Failure, Cardiac Arrythmias and Valvular Heart Disease. Weighted samples were utilized and p

Circulation, Volume 150, Issue Suppl_1, Page A4141644-A4141644, November 12, 2024. Background:Previous studies have shown conflicting results regarding higher rates of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) among women as compared to men. We sought to identify covariates that explain possible sex differences in rates of CI-AKI after PCI.Methods:This was a retrospective observational cross-sectional study of all PCIs performed at Cedars-Sinai Medical Center from 2020-2023, sourced from the National Cardiovascular Data Registry. The primary outcome and regressor were CI-AKI and sex, respectively. Covariates were other patient demographics, comorbidities, procedural factors, and health insurance. We excluded patients with pre-PCI dialysis requirement or without pre/post-PCI creatinine. We used multivariable-adjusted logistic regression to evaluate rates of CI-AKI among women versus men. Using additive adjustment, we identified factors that accounted for the sex differences.Results:Of 2971 PCIs included, 820 (27.6%) were performed in women, 316 (10.6%) in Black patients and 283 (9.5%) in Hispanic patients. On average, women were older than men (73.9 vs 68.6 years, p

Circulation, Volume 150, Issue Suppl_1, Page A4145242-A4145242, November 12, 2024. Background:Acute myocardial infarction (AMI) is a critical global health issue requiring effective secondary prevention strategies. Current guidelines advocate for beta-blockers (BB) in STEMI and NSTEMI cases due to their mortality benefits. However, these guidelines often overlook individual patient variability, necessitating personalized treatment approaches. This study aims to develop a machine learning (ML) model to predict individualized mortality in AMI patients and evaluate the relative benefits of BB across diverse patient profiles to enhance clinical outcomes.Methods:We analyzed 12,599 AMI patients in the Korea AMI Registry (KAMIR)-National Institutes of Health (NIH) dataset. Patients were randomly divided into a training set (n = 8,467) and a testing set (n = 4,132) by a 2:1 ratio. Patients were categorized into four quartiles based on Mortality Risk Differences determined by our ML model, indicating increasing benefits from BB therapy. Quartiles Q1 and Q2 (Low-Risk group) showed smaller differences in mortality risks, while Q3 and Q4 (High-Risk group) showed larger benefits.Results:Among various ML models, Binary GLM Logistic Regression performed best, achieving an AUC of 0.8428. Our evaluations focused on patients with anemia, those aged over 65, eGFR below 60 and eGFR below 90. These factors were selected because they demonstrated the greatest information gain according to the ‘information gain attribute evaluation’ in the high-risk group. when analyzing the total test group within these groups, there was a noticeable survival advantage for patients in the BB group compared to those not on BB. (p = 0.009, p < 0.001, p = 0.003, p < 0.001). However, there was no significant difference noted among the groups within the low-risk group.Conclusion:This study highlights the potential of ML to enhance personalized medicine in AMI management, particularly in optimizing BB treatment. By utilizing detailed patient data, our model facilitates more personalized treatments that are specifically aligned with individual patient needs, thereby improving clinical outcomes. This approach not only enhances the effectiveness of interventions but also embodies the principles of precision medicine, adapting treatment strategies to optimally suit each patient's unique clinical profile.

Circulation, Volume 150, Issue Suppl_1, Page A4136286-A4136286, November 12, 2024. Introduction:Large bore thrombectomy is increasingly used to treat acute PE. Post-market surveillance using the U.S. FDA Manufacturer and User Facility Device Experience (MAUDE) database may capture serious device adverse events (AE) not described in small pre-market clinical trials. We aim to analyze serious AE associated with use of the Inari Medical (Irvine, California) large bore thrombectomy system to treat PE.Methods:All MAUDE events between January 1, 2018 and May 1, 2024 involving PE treatment with Triever and Flowtriever devices were reviewed and categorized based on device type, incident year, and clinical event. Based on narrative description, AE were placed into categories of cardiac, pulmonary, device malfunction, anemia, and other.Results:A total of 58 AE reports representing 50 unique clinical episodes were included. MAUDE event types were death (n=32), injury (n=23) and malfunction (n=3), and the majority (45/58) involved the larger aspiration catheters (Table 1). Death occurred in 27 of 50 unique episodes. Cardiac injury (n=19) and pulmonary injury (n=18) were most common and included 25 serious perforations. Serious AEs are listed in Table 2. Device malfunction/improper use was rare (n=7) and was not associated with death. Paradoxical embolism was described causing stroke and coronary occlusion. 3 of 4 blood loss AEs occurred prior to 2021.Conclusion:This report includes the largest description of reported AEs with large bore aspiration thrombectomy systems used to treat PE. This report describes serious events, often associated with death, that are likely infrequent and were not detected in pivotal studies or registries. Understanding these AEs may guide future technique and device refinement, and the current findings demonstrate the importance of large post-approval studies.

Circulation, Volume 150, Issue Suppl_1, Page A4145777-A4145777, November 12, 2024. Background:The literature regarding outcomes among patients with coagulopathy who had left atrial appendage occlusion (LAAO) device procedure is limited. This study evaluated the inpatient outcomes among patients that underwent LAAO with and without diagnosed coagulable disorders.Methods:Patients that underwent LAAO were collected from the National Inpatient Sample database 2016-2019. Patients were stratified by the presence of diagnosed coagulable disorders. Demographic and comorbidity data were collected. Bleeding events and inpatient mortality were assessed. Chi-square and binary logistic regression analyses were utilized. Factors with p

Circulation, Volume 150, Issue Suppl_1, Page A4139307-A4139307, November 12, 2024. Introduction:Heart failure (HF) is associated with unique comorbidities and sequelae, which can affect clinical presentation and patient outcomes. This is specifically challenging when patients are evaluated for suspected acute coronary syndrome (ACS). We sought to compare the most important predictors of poor outcomes in patients with and without HF seen in the emergency department (ED) for ACS.Methods:This was a secondary analysis of a prospective observational cohort study of consecutive patients seen for symptoms suggestive of ACS, such as chest pain (CP) and dyspnea, in the EDs of three UPMC-affiliated tertiary care hospitals (NCT04237688, clinicaltrials.gov). Primary outcome was 30-day major adverse cardiac events (MACE), adjudicated by two independent reviewers. Clinical data were collected form charts and we used KNN to impute missing data for features, most of which had less than 12.5% missingness. For features with greater than 12.5% missingness (i.e., BNP, Mg), binary indicators were added to flag missing values. Data were normalized using the Euclidean norm. Two random forest (RF) classifiers were trained using 10-fold cross validation with 71 manually selected features available early in the ED course (i.e., vital signs, labs, past medical history, ECG), and tested on patients with and without known HF. Model performance was evaluated using AUROC, and top features were identified with SHAP values.Results:The sample included 2400 patients (age 59 ± 16 years; 47% female, 41% Black, 15.9% ACS), of whom 438 had HF (age 66 ± 14 years; 45% female, 49% Black, 15.1% ACS). Individuals with HF were more likely to experience MACE (38% vs 23%,p

Circulation, Volume 150, Issue Suppl_1, Page A4141578-A4141578, November 12, 2024. Background:Angiopoietin-like protein 3 (ANGPTL3) has garnered attention as a target for managing clinical lipid profiles. However, the determinants of blood ANGPTL3 levels and their prognostic significance in cardiovascular disease (CVD) remain unclear.Aims:This study aimed to investigate the clinical determinants and prognostic significance of serum ANGPTL3 levels in patients with CVD.Methods:A total of 311 patients with CVD (mean age 71 years, 61% male, mean body mass index 24 kg/m2, 42% diabetic, median estimated glomerular filtration rate (eGFR) 57 mL/min/1.73 m2, 152 patients with ischemic heart disease, 75 with valvular heart disease, 30 with cardiomyopathy, 54 with other CVD) were enrolled. Serum ANGPTL3 levels were measured using an enzyme-linked immunosorbent assay (R&D Systems) and analyzed for associations with clinical characteristics and the incidence of major adverse cardiovascular events (MACE), including all-cause mortality, non-fatal myocardial infarction, heart failure hospitalization, and ischemic stroke during a one-year follow-up.Results:Serum ANGPTL3 levels were significantly higher in females than in males (92 [78-112] vs. 74 [56-94] ng/mL, p < 0.0001). These levels showed positive correlations with age and the levels of CRP and BNP, while negative correlations were observed with eGFR, total bilirubin (T-bil), alanine aminotransferase (ALT), albumin (Alb), hemoglobin (Hb), and platelet counts. No association was found with lipid profiles or specific CVD etiologies. Multivariate analysis identified gender, CRP, eGFR, ALT, and Hb levels as independent determinants of serum ANGPTL3 levels. During the follow-up period, 30 patients developed cardiovascular events, and receiver operating characteristic curve analysis identified a serum ANGPTL3 cutoff of 90.7 ng/mL for optimal event discrimination. Kaplan-Meier analysis showed a significantly higher incidence of MACE in patients with ANGPTL3 levels above the cutoff than those below (log-rank test, p = 0.0013). Multivariate Cox regression analysis identified elevated ANGPTL3 level as an independent determinant of MACE (hazard ratio: 1.01; 95% confidence interval: 1.00-1.02; p = 0.018).Conclusions:In patients with CVD, serum ANGPTL3 levels, determined by gender, inflammation, liver and renal function, and anemia, can discriminate populations at high risk of developing future cardiovascular events.

Circulation, Volume 150, Issue Suppl_1, Page A4124313-A4124313, November 12, 2024. A 30-year-old male electrician presented with two days of fever and positional left shoulder pain and was found to have elevated inflammatory markers and a large pericardial effusion with echocardiographic evidence of tamponade for which he underwent pericardiocentesis. He was discharged on a course of anti-inflammatory therapy with presumed diagnosis of idiopathic pericarditis based on negative cytology. He returned 6 months later with several weeks of upper respiratory infection symptoms as well as new abdominal discomfort and emesis.On presentation, his vital signs were notable for tachycardia to 113 and cardiac exam was notable for tachycardia, regular rhythm, no rubs or murmurs, nondisplaced precordial impulse, normal jugular venous pressure with Kussmaul sign, and pulsus paradoxus of 6. An electrocardiogram showed sinus tachycardia with diffuse ST segment changes (Figure A). His cardiac biomarkers were unremarkable (troponin 21). His labs revealed normocytic anemia with hemoglobin of 11 and erythrocyte sediment rate above assay. Echocardiogram demonstrated a circumferential complex pericardial effusion with echocardiographic evidence of early tamponade (Figure B, C). A pericardiocentesis was attempted with inability to advance wire within pericardial space. A malignancy workup was initiated. CT demonstrated multi-station thoracic and lower cervical lymphadenopathy, moderate left pleural effusion, and an intrapericardial mass with associated pericardial effusion (Figure D). Cardiac magnetic resonance imaging demonstrated a circumferential intrapericardial non-mobile mass measuring up to 22 mm in thickness posteriorly and the mass was isointense to myocardium indicating low-fat content (Figure E). A supraclavicular lymph node biopsy was obtained with immunohistochemical staining positive for WT1 and calretinin, consistent with metastatic epithelioid mesothelioma of pericardial versus pleural etiology (Figure F). A PET-CT subsequently showed a FDG-avid circumferential anterior pericardial mass and multiple pleural-based lesions concerning for metastatic mesothelioma. He was initiated on pemetrexed/carboplatin systemic chemotherapy. With systemic therapy, his disease has been stable for 6 months. Pericardial mesothelioma is a rare malignancy. This case underscores the diagnostic challenges associated with pericardial mesothelioma and the importance of cancer workup as part of the pericardial effusion workup.

Circulation, Volume 150, Issue Suppl_1, Page A4142305-A4142305, November 12, 2024. Background:Demand ischemia is typically ascribed little importance but likely indicates an elevated cardiovascular risk that is more significant than current convention dictates, despite the absence of plaque rupture.Hypothesis:Demand ischemia likely predicts worse 3-month cardiovascular outcomes in patients with nonocclusive CAD admitted for nonsevere sepsis.Methods:We conducted a retrospective cohort study using data from the National Readmissions Database 2017 to 2020 to evaluate whether demand ischemia predicts increased risk of 3-month readmission with adverse cardiovascular outcomes in patients with nonocclusive CAD admitted for nonsevere sepsis. The outcomes of interest were 3-month readmissions with acute heart failure, ventricular tachyarrhythmia, cardiogenic shock, STEMI, acute respiratory failure, AKI and vasopressor use. Multivariate analysis was employed to derive adjusted odds ratios (OR) after accounting for age, Charlson comorbidity index, household income, hospital location and size, hypertension, diabetes mellitus, hyperlipidemia, CHF, atrial fibrillation/flutter, CKD, tobacco use, anemia, malnutrition, obesity, OSA and OHS.Results:Among patients with nonocclusive CAD admitted for nonsevere sepsis, 717,110 did not have demand ischemia, compared to 25,728 patients who did. In patients with demand ischemia, our results showed significantly increased risk of 3-month readmission with acute heart failure (OR 2.10, P < 0.0005, CI 2.00 – 2.19), ventricular tachyarrhythmia (OR 2.51, P < 0.0500, CI 1.19 – 5.34), cardiogenic shock (OR 1.66, P < 0.0005, CI 1.45 - 1.90), acute respiratory failure (OR 1.97, P < 0.0005, CI 1.89 – 2.05), AKI (OR 1.48, P < 0.0005, CI 1.42 – 1.54) and vasopressor use (OR 1.52, P < 0.0005, CI 1.31 – 1.78) There were no cases of 3-month readmissions with STEMI, possibly due to coding.Conclusion:Our results indicate that despite being considered a relatively benign diagnosis, demand ischemia is likely actually a marker for meaningfully elevated cardiovascular risk. Further studies will be needed to support this idea and to identify interventions that mitigate the risk.

Circulation, Volume 150, Issue Suppl_1, Page A4145703-A4145703, November 12, 2024. Introduction:Acute coronary syndrome (ACS) is a leading cause of cardiovascular (CV) death. Sickle cell disease (SCD) is the most common inherited blood disorder in the United States and is associated with coronary microvascular dysfunction and impaired myocardial perfusion reserve. However, data on post-ACS outcomes in patients with SCD are scarce.Methods:Patients admitted with ACS from 2014-2020 with and without SCD were identified using the National Readmissions Database. In-hospital outcomes were death, major bleeding, stroke or arterial thromboembolism, and venous thromboembolism (VTE). Ninety-day readmission outcomes were CV-related, heart failure (HF) related, bleeding-related, and all-cause. Multivariable logistic or Cox proportional hazards were utilized with age, sex, chronic kidney disease, prior MI, prior stroke, prior VTE, pulmonary hypertension, STEMI, cardiogenic shock, revascularization, anemia, mechanical circulatory support use, hospital size and teaching status in addition to social factors as co-variables.Results:A total of 2,190,358 patients with ACS were included, of whom 1,471 (0.067%) had SCD. After multivariable adjustment, there was no difference in in-hospital mortality (OR 0.92; 95% CI 0.68-1.26) or major bleeding (OR 1.03; 95% CI 0.82-1.28) between patients with and without SCD. There was no significant difference in 90-day CV-related (HR 1.11; 95% CI 0.94-1.3) or bleeding-related (HR 0.86; 95% CI 0.49-1.52) readmissions between patients with and without SCD. However, SCD was associated with a higher rate of HF-related (HR 1.25; 95% CI, 1.04-1.52) and all-cause 90-day readmissions (HR 1.17; 95% CI, 1.04-1.32).Conclusion:Among patients admitted with ACS, SCD was not associated with increased risk of in-hospital outcomes though there was an association of increased HF-related and all-cause 90-day readmissions with SCD. Further investigation is needed to better characterize and improve outcomes of patients with SCD and ACS.

Circulation, Volume 150, Issue Suppl_1, Page A4131460-A4131460, November 12, 2024. Background:Chronic kidney disease (CKD) is associated with risk of myocardial infarction (MI) and anemia. Among patients with CKD and anemia who experience MI, it remains uncertain if a liberal transfusion threshold (LTT) strategy (hemoglobin cutoff [Hgb] < 10 g/dL) is superior to a restrictive transfusion threshold (RTT, Hgb 7-8 g/dL) strategy.Objectives:To evaluate outcomes of those with CKD randomized to RTT vs. LTT in the Myocardial Ischemia and Transfusion (MINT) trial (NCT02981407).Methods:Among 3,495 MINT participants with non-missing creatinine (99.7%), we compared the baseline characteristics and outcomes at 30 days post-randomization of those individuals without CKD (N = 1279), CKD with eGFR 30-60 mL/min/1.73 m2(N = 999), CKD with eGFR < 30 mL/min/1.73 m2(N = 802), and CKD requiring dialysis (N = 415), both overall and by randomized transfusion strategy. Interaction terms for eGFR category by treatment assignment on each outcome were assessed.Results:Individuals with CKD compared to those without CKD more frequently presented with NSTEMI (all p < 0.001) and had a greater risk of all-cause death, recurrent MI, rehospitalization, and heart failure (all p < 0.05). Compared to a liberal transfusion strategy, a restrictive strategy among non-dialysis dependent individuals with an eGFR < 30 mL/min/1.73 m2was associated with an increased risk of death/recurrent MI (Figure 1) and unplanned rehospitalization (Figure 2). Among individuals with an eGFR 30-60 mL/min/1.73 m2, a restrictive strategy was associated with an increased risk of cardiac death (Figure 1). No eGFR category by treatment assignment interaction terms were significant.Conclusions:In this prespecified analysis, individuals with CKD were at greater risk of death, recurrent MI, heart failure, and unplanned rehospitalization at 30 days post-randomization than those without CKD. In individuals with CKD, a restrictive transfusion strategy was associated with increased risk of adverse outcomes.