New ACC/AHA Guidelines Include Transfusion Strategies for ACS Management

March 12, 2025

The American College of Cardiology (ACC) and the American Heart Association (AHA) recently published updated guidelines for the management of patients with acute coronary syndrome (ACS) in the Journal of the American College of Cardiology and Circulation.

Of note for the AABB community, the guidelines include a class 2b recommendation suggesting that it may be reasonable to transfuse red blood cells to maintain a hemoglobin level of at least 10 g/dL in patients with acute or chronic anemia who are not actively bleeding. This recommendation was informed in part by findings from the Myocardial Ischemia and Transfusion (MINT) Trial, which suggested a possible short-term clinical benefit in targeting a hemoglobin level around 10 g/dL. The trial’s primary endpoint — 30-day death or recurrent MI – was not statistically significant.

In addition to the transfusion recommendation, the ACC/AHA guidelines provide guidance on procedural considerations, antiplatelet therapy and secondary prevention strategies aimed at improving patient outcomes.