Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cost-effectiveness and Cost-utility of Liberal vs Restrictive Red Blood Cell Transfusion Strategies in Patients With Acute Myocardial Infarction and Anaemia. The REALITY (REstrictive And LIberal Transfusion Strategies in Patients With Acute mYocardial Infarction) Randomized Trial.
Brief Summary: Anemia in patients with myocardial infarction (MI) is a relatively frequent issue, resulting in poorer outcome. There is equipoise regarding which transfusion strategy is best, and there is an international consensus on the urgent need for a randomized trial.

The investigators hypothesize that a "restrictive" transfusion strategy is at least non-inferior to a "liberal" transfusion strategy on 30-day outcomes of MI patients with anemia. Given the costs and risks of transfusion, a cost-effectiveness and cost-utility analysis becomes key to determining the role of each strategy.


Options:
A: Inclusion Criteria:

* Hospitalized patients with hemoglobin level less than 100 g/L who present with an ST-segment Elevation Myocardial Infarction (STEMI), or Non-ST-Elevation Myocardial Infarction (NSTEMI);
* Rise in cardiac biomarker values with at least one value above the 99th percentile (preferably cardiac troponin cTn )
* Presence of one of the following:

  * symptoms of ischemia;
  * new/presumed new ST segment-T wave (ST-T) changes or new left bundle branch (LBBB);
  * development of pathological Q waves;
  * imaging evidence of new loss of viable myocardium or new regional wall motion abnormality;
  * identification of an intracoronary thrombus by angiography

Exclusion Criteria:

* Patients with uncontrolled acute bleeding at the time of randomization defined as the need for uncrossed or non-type specific blood;
* Patients who decline blood transfusion;
* Patients who have a planned cardiac surgery or immediate post-cardiac surgery;Patients who have been deemed palliative by their treatment team (no commitment to aggressive on-going care);
* If known that follow-up will not be possible at 30 days;
* Previous participation in the MINT Trial.
B: Inclusion Criteria:

* at least 18 years of age
* were to undergo isolated on-pump CABG
* were able to give informed consent

Exclusion Criteria:

* performed autologous blood donation
* underwent off-pump CABG
* emergency procedure
* resternotomy
* known bleeding disorder not drug related
* history of heparin-induced thrombocytopenia
* Jehovah's Witness
* intra-operative catastrophe prior to randomization
C: Inclusion Criteria:

* Aged ≥ 18 years
* Recent acute myocardial infarction, with or without ST- segment elevation, with a combination of ischemic symptoms occurring in the past 48 hours,before the MI related admission, and elevation of biomarkers of myocardial injury (troponin)
* Anemia Hb ≤ 10g / dL but \> 7 g/dL on Hb, measured at any time during the index hospital admission for MI.
* Written informed consent
* Coverage for medical insurance.

Exclusion Criteria:

* Shock (SBP \< 90 mmHg with clinical signs of low output or patients requiring inotropic agents)
* MI occurring post-percutaneous coronary intervention (PCI) or post-coronary artery bypass graft (CABG) (i.e. type IV or V Acute MI according to the 2012 Universal Definition of MI
* Life-threatening or massive ongoing bleeding (as judged by the investigator)
* Any blood transfusion in the previous 30-days
* any known malignant hematologic disease Note: Sickle cell disease, thalassemia and anemia due to chronic renal failure (even under EPO) are not an exclusion criteria
D: Inclusion Criteria:

* Clinical diagnosis of hip fracture
* Surgery treatment
* Living in nursing homes or sheltered housing facilities
* Haemoglobin level between 6 and 7 mmol/l latest 6th day after surgery
* Written consent

Exclusion Criteria:

* Active cancer
* Pathological fracture
* The patient is against blood transfusion

Answer: C