SynthesisJournal of cardiothoracic surgery2023
The efficacy of intravenous iron for treatment of anemia before cardiac surgery: An updated systematic review and meta-analysis with trial sequential analysis.
Synthesis in Journal of cardiothoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Preoperative anemia and anemia treatment in cardiac surgery: a systematic review and meta-analysis.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Pooled it
- Patient blood management protocol reduces allogeneic transfusion, morbidity, and mortality in coronary artery bypass surgery.Journal of cardiothoracic surgery · 2026Article
- Iron deficiency anemia in pregnancy: prevention, diagnosis and treatment: Number 5 - 2026.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2026Article
- Associations between persistent postoperative anaemia and mortality 1 year after valvular heart surgery: a retrospective cohort study.Anaesthesia · 2026Article
- Anemia and Iron Deficiency in Cardiac Surgery Patients: Prevalence, Implications, and Therapeutic Considerations.Journal of clinical medicine · 2025Review
- Timing of intravenous iron for treatment of anaemia in surgical patients: a systematic review and network meta-analysis.EClinicalMedicine · 2025Article
- Start Strong, Finish Strong: A Review of Prehabilitation in Cardiac Surgery.Life (Basel, Switzerland) · 2024Review
- Iron as an emerging therapeutic target in critically ill patients.Critical care (London, England) · 2023Review
- Management and perceptions of anemia and iron deficiency prior to cardiac surgery.Archivos peruanos de cardiologia y cirugia cardiovascularArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreoperative anemia is common in patients undergoing cardiac surgery with various etiologies, among which iron deficiency is the leading cause. However, the benefit of intravenous (IV) iron for the treatment of anemia before cardiac surgery is uncertain. This updated meta-analysis aimed to evaluate the efficacy of IV iron in adult cardiac surgery patients with preoperative anemia.
methodsThis review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched Embase, PubMed and the Cochrane Central Register of Controlled Trials to identify eligible randomized controlled trials (RCTs) and observational studies. Quality was assessed using the Cochrane Collaboration risk of bias tool and Newcastle-Ottawa scale, and the strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria. Trial sequential analysis was performed on the primary outcome (transfusion rate) to confirm whether firm evidence was reached.
resultsSix RCTs (936 patients) and 5 observational studies (1350 patients) were included in this meta-analysis. The IV iron group and the control group were comparable in terms of transfusion rate [55.1% vs 60.9%, risk ratio (RR) = 0.91, 95% confidence interval (CI) 0.81-1.03, P = 0.13, low quality]. There were no significant differences in units transfused per patient, ICU stay and hospital length of stay between the two groups. And pooled data showed a benefit of IV iron compared to the control group on mortality (2.76% vs 3.75%, RR = 0.58, 95% CI 0.36-0.95, P = 0.03, moderate quality) and no mortality reduction existed when including only RCTs.
conclusionsThis meta-analysis suggested that IV iron treatment for patients with anemia before cardiac surgery did not reduce the transfusion requirement (low quality), but it was associated with decreased mortality (moderate quality). More large-scale, high-quality randomized clinical trials are warranted to confirm or refute our findings. PROSPERO registry reference: CRD42022331875.
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