Forty patients (22.4%) had evidence of cardiac disease, with similar pre-transfusion Hb for patients with and without cardiac disease (median Hb 79 g/L vs. 81 g/L, p = 0.1).<h4>Discussion</h4>Patients with MDS frequently require RBC transfusion, and restrictive transfusion strategies predominate despite many patients having cardiac comorbidities. This evidence concerns the gene GSTM1 and myelodysplastic syndrome.