Be careful using a restrictive transfusion strategy in patients with cardiovascular disease

From a recent review:

There is biological plausibility that patients with CVD may benefit from higher transfusion thresholds than patients without CVD. Evidence from a systematic review and meta‐analysis in this population suggest that there is no difference in 30‐day mortality, but there is an increased risk of ACS in patients with CVD who were randomized to a restrictive transfusion threshold compared with a more liberal threshold. We suggest that a more liberal transfusion threshold (greater than 80 g/l) in this population should be used until a high‐quality trial including endpoints for longer term mortality, ACS, quality of life and cost effectiveness has been performed.