Intravenous iron therapy for patients with preoperative iron deficiency or anaemia undergoing cardiac surgery reduces blood transfusions: a systematic review and meta-analysis

• Published in: Interactive cardiovascular and thoracic surgery 2020-08, Vol.31 (2), p.141-151
• Main Authors: Gupta, Saurabh, Panchal, Puru, Gilotra, Kevin, Wilfred, Ann Mary, Hou, Winston, Siegal, Deborah, Whitlock, Richard P, Belley-Cote, Emilie P
• Format: Article
• Language: English
• Subjects: Administration, Intravenous; Anemia - blood; Anemia - complications; Anemia - therapy; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - complications; Anemia, Iron-Deficiency - therapy; Blood Transfusion - trends; Cardiac Surgical Procedures; Heart Diseases - complications; Heart Diseases - surgery; Humans; Iron - administration & dosage
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivaa094

The benefits of preoperative intravenous (IV) iron treatment in cardiac surgery patients with preoperative anaemia or iron deficiency have not been well-established. We performed a systematic review and meta-analysis to determine the effects of treating preoperative anaemia or iron deficiency with IV iron in adult cardiac surgery patients. We searched Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval Systems Online and Excerpta Medica Database for randomized controlled trials (RCTs) and observational studies comparing IV iron to oral iron or no iron. We performed title and abstract, full-text screening, data extraction and risk of bias assessment independently and in duplicate. We pooled data using a random effects model and evaluated the overall quality of evidence. We identified 4 RCTs and 7 observational studies. Pooled data from observational studies suggested a benefit of IV iron compared to no iron on mortality [relative risk 0.39, 95% confidence interval (CI) 0.23-0.65; P