Anemia Acuity Effect on Transfusion Strategies in Acute Myocardial Infarction: A Secondary Analysis of the MINT Trial

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 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</p

Girls Rock! Fifty Years of Women Making Music

Girls Rock! explores the many ways women have defined themselves as rock musicians in an industry once dominated and controlled by men. Integrating history, feminist analysis, and developmental theory, the authors describe how and why women have become rock musicians—what inspires them to play and perform, how they write, what their music means to them, and what they hope their music means to listeners. As these musicians tell their stories, topics emerge that illuminate broader trends in rock’s history. From Wanda Jackson’s revolutionary act of picking up a guitar to the current success of independent artists such as Ani DiFranco, Girls Rock! examines the shared threads of these performers’ lives and the evolution of women’s roles in rock music since its beginnings in the 1950s. This provocative investigation of women in rock is based on numerous interviews with a broad spectrum of women performers—those who have achieved fame and those just starting bands, those playing at local coffeehouses and those selling out huge arenas. Girls Rock! celebrates what female musicians have to teach about their experiences as women, artists, and rock musicians. Chosen for the 2005 Amelia Bloomer Recommended List of the American Library Association. The stories are touching, personal, gritty, real, and political. . . . It gave me a sense of a legacy, that we have grandmas who\u27ve been building these bridges for us. It\u27s a powerful thing to be written into being, to illuminate the hidden stories with joy. —Clamor An exploration of women as musicians, their relationship to the music industry, and the way women construct their identities as girls who rock. —Corvallis (OR) Gazette-Times Combines feminist analysis, history, and developmental theory to describe women\u27s journey on the rock \u27n\u27 roll road. —Eugene (OR) Register-Guard Treats female rockers with the depth and seriousness that they deserve and have all to often been denied. —Iola (WI) Goldmine Manages to avoid the conflation of popular music to pop stars and instead to incorporate lesser-known musicians into the history of rock. —Journal of Material Culture Sets out to find out how women develop identities as rock \u27n\u27 roll musicians. It\u27s not a book about women and rock; rather, Girls Rock! Discusses women\u27s relationship to rock. —Portland Oregonian Carson, Lewis, and Shaw have written a book that fills a significant gap in the current discourse on women in popular music. They examine the connection between selfhood and music-making in a way that both validates and honors the unique experience of women in rock-and-roll. These girls rock! —Teresa Reed, author of The Holy Profane: Religion in Black Popular Musichttps://uknowledge.uky.edu/upk_cultural_history/1018/thumbnail.jp