Blood transfusion in patients with coronary syndromes and anaemia: a systematic review and a meta-analysis of randomized controlled trials

Abstract Background The estimated prevalence of anaemia on admission in the setting acute coronary syndromes (ACS) is between 10 to 43% and up 57% patients may develop hospital-acquired anaemia. best blood transfusion strategy anemic with symptomatic remains unclear. Purpose We aimed perform a systematic review meta-analysis randomized controlled trials (RCT) assess effect different strategies 30-day mortality, major adverse cardiovascular events (MACE), non-cardiovascular complications. Methods searched for all comparing restrictive conservativestrategy published 16 th November 2021 PubMed, Embase, Cochrane Central Register Controlled Trials (CENTRAL), ClinicalTrials.gov without language, sample size, publication date or other data restrictions. All studies were assessed bias using risk bias, meta-analysed random model. quality evidence was evaluated by Grading Recommendations, Assessment, Development Evaluation (GRADE) approach. pre-specified primary outcome all-cause death at 30 days. secondary composite non-fatal recurrent myocardial infarction, stroke, emergency revascularization, days (MACE). Safety endpoint combination de novo worsening congestive heart failure, stent thrombosis, venous thromboembolism, pneumonia, stream infection. Results Three RCT (CRIT, MINT REALITY) included 820 patients. considered low, except blinding healthcare professionals. Across three studies, total 55 died first found no differences compared liberal (risk ratio [RR]: 1.61, 95% confidence interval [CI] 0.38–6.90, I2=59%, MACE (RR: 1.16, CI 0.49–2.71; I2=62%; figure 1) incidence 1.52, 0.56–4.09; I2=60%; 2). low moderate due concerns imprecision inconsistency. Conclusion(s) Liberal conservative show similar results anaemic syndromes. As scarce resource, our support current guideline recommendation Funding Acknowledgement Type funding sources: None.