{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T16:28:15Z","timestamp":1773160095123,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T00:00:00Z","timestamp":1524096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To evaluate the risks of restrictive red blood cell transfusion strategies (haemoglobin 7\u20138\u00a0g\u2009dL\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) in patients with and without known cardiovascular disease (CVD).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent guidelines recommend restrictive strategies for CVD patients hospitalised for non\u2010CVD indications, patients without known CVD and patients hospitalised for CVD corrective procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\/Materials<\/jats:title>\n                    <jats:p>Database searches were conducted through December 2017 for randomised clinical trials that enrolled patients with and without known CVD, hospitalised either for CVD\u2010corrective procedures or non\u2010cardiac indications, comparing effects of liberal with restrictive strategies on major adverse coronary events (MACE) and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In CVD patients not undergoing cardiac interventions, a liberal strategy decreased (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090\u00b701) the relative risk (95% CI) (RR) of MACE [0\u00b750 (0\u00b729\u20130\u00b786)] (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u20090%). Among patients without known CVD, the incidence of MACE was lower (1\u00b77 vs 3\u00b79%), and the effect of a liberal strategy on MACE [0\u00b779, (0\u00b739\u20131\u00b758)] was smaller and non\u2010significant but not different from CVD patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090\u00b730). Combining all CVD and non\u2010CVD patients, a liberal strategy decreased MACE [0\u00b759, (0\u00b739\u20130\u00b791);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090\u00b702]. Conversely, among studies reporting mortality, a liberal strategy decreased mortality in CVD patients (11\u00b77% vs\u00b713\u00b73%) but increased mortality (19\u00b72% vs 18\u00b70%) in patients without known CVD [interaction\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090\u00b705; ratio of RR 0\u00b773, (0\u00b753\u20131\u00b700)]. A liberal strategy also did not benefit patients undergoing cardiac surgery; data were insufficient for percutaneous cardiac procedures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients hospitalised for non\u2010cardiac indications, liberal transfusion strategies are associated with a decreased risk of MACE in both those with and without known CVD. However, this only provides a survival benefit to CVD patients not admitted for CVD\u2010corrective procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tme.12535","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T02:26:07Z","timestamp":1524191167000},"page":"335-345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Risks of restrictive red blood cell transfusion strategies in patients with cardiovascular disease (CVD): a meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"given":"I.","family":"Cort\u00e9s\u2010Puch","sequence":"first","affiliation":[{"name":"Critical Care Medicine Department, Clinical Center National Institutes of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. M.","family":"Wiley","sequence":"additional","affiliation":[{"name":"Critical Care Medicine Department, Clinical Center National Institutes of Health  Bethesda Maryland USA"},{"name":"Department of Cardiovascular Diseases Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Sun","sequence":"additional","affiliation":[{"name":"Critical Care Medicine Department, Clinical Center National Institutes of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. G.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, Clinical Center National Institutes of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Welsh","sequence":"additional","affiliation":[{"name":"National Institutes of Health Library National Institutes of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. L.","family":"Danner","sequence":"additional","affiliation":[{"name":"Critical Care Medicine Department, Clinical Center National Institutes of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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