Recurrent myocardial infarction identified by centralized troponin review: Insights from the MINT trial.

Sarang Kim; Marnie Bertolet; Bernard R Chaitman; John H Alexander; Philippe Gabriel Steg; Renato D Lopes; Tabassome Simon; Shaun G Goodman; Jordan B Strom; Pedro G M de Barros E Silva; Gregory Ducrocq; Andrew P DeFilippis; Maria M Brooks; Jeffrey Carson; MINT Trial Investigators

doi:10.1016/j.ahj.2026.107553

PubMed · 42571785

Recurrent myocardial infarction identified by centralized troponin review: Insights from the MINT trial.

Sarang Kim·Marnie Bertolet·Bernard R Chaitman·John H Alexander·Philippe Gabriel Steg·Renato D Lopes·Tabassome Simon·Shaun G Goodman·Jordan B Strom·Pedro G M de Barros E Silva·Gregory Ducrocq·Andrew P DeFilippis·Maria M Brooks·Jeffrey Carson·MINT Trial Investigators

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Abstract

BACKGROUND: The utility of routine troponin testing to identify recurrent myocardial infarction (MI) after an incident MI is unclear. We assessed the incidence and prognosis of recurrent MIs identified from centralized troponin review in patients from the Myocardial Ischemia and Transfusion (MINT) trial. METHODS: The MINT trial randomized patients with acute MI and anemia to a liberal vs restrictive red blood cell transfusion strategy. Suspected recurrent MIs were identified through both site-report and centralized review of troponin levels collected for 3 days following randomization. Differences in cardiac, noncardiac, and all-cause death at 30 and 180 days were compared across patients with any site-reported MI, only centrally identified MI, and no recurrent MI. RESULTS: Among 3,504 patients, 275 (7.8%) had a recurrent MI within 30 days; 119 (43.3%) by site-report, and 156 (56.7%) by central troponin review only. Rates of cardiac and all-cause death at 30 and 180 days were highest for patients with site-reported MI, intermediate for centrally identified MI, and lowest for no recurrent MI; rates of noncardiac death did not vary. Patients with only centrally identified recurrent MI had an increased risk of cardiac death at 30 days (RR 1.9, 95% CI 1.0-3.4) and 180 days (RR 1.7, 95% CI 1.1-2.7) compared to those without recurrent MI. CONCLUSIONS: In patients with acute MI and anemia, centralized troponin review identified more than half of all recurrent MI events. Patients with centrally identified MI had a higher risk of cardiac death than those with no recurrent MI. TRIAL REGISTRATION: ClinicalTrials.gov NCT02981407 https://clinicaltrials.gov/study/NCT02619136.

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Humans Myocardial Infarction Male Recurrence Female Aged Middle Aged Troponin Prognosis Biomarkers Anemia Erythrocyte Transfusion Incidence Cause of Death Journal Article Randomized Controlled Trial Multicenter Study

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Sarang Kim, Marnie Bertolet, Bernard R Chaitman, John H Alexander, Philippe Gabriel Steg, Renato D Lopes, Tabassome Simon, Shaun G Goodman, Jordan B Strom, Pedro G M de Barros E Silva, Gregory Ducrocq, Andrew P DeFilippis, Maria M Brooks, Jeffrey Carson, MINT Trial Investigators. 2026-08-09. Recurrent myocardial infarction identified by centralized troponin review: Insights from the MINT trial.. https://doi.org/10.1016/j.ahj.2026.107553

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Journal Article; Randomized Controlled Trial; Multicenter Study resource Aged subject Anemia subject Biomarkers subject Cause of Death subject Erythrocyte Transfusion subject Female subject Humans subject Incidence subject Journal Article subject Male subject Middle Aged subject Multicenter Study subject Myocardial Infarction subject Randomized controlled trials study

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