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Getting the latest healthcare news for you
A single IV iron infusion before elective cardiac surgery leads to better recovery and fewer blood transfusions, according to the randomized ITACS trial. Patients who received IV iron spent about one extra day alive and at home within 90 days post-op — a modest but meaningful gain. The real standout? IV iron saved an estimated 44 units of blood products per 100 patients treated.
Treating anemia with a single intravenous iron infusion before elective cardiac surgery improves patient recovery and significantly reduces the need for blood transfusions, according to the ITACS trial published in The BMJ. The large randomized study, conducted across 33 hospitals in 10 countries, enrolled 955 adults with anemia prior to cardiac surgery and compared a single 1,000 mg IV iron dose against placebo given 1 to 26 weeks before the operation.
Patients who received IV iron had higher hemoglobin and ferritin levels by surgery day and were less likely to need red blood cell transfusions at every measured timepoint. For patients with the worst recovery trajectories, the benefit was even more pronounced — translating to 6–10 extra days at home.
By the Numbers:
Why it matters: Anemia affects roughly one-third of cardiac surgery patients and is often undertreated. This trial provides strong evidence that a cheap, safe, single-dose IV iron infusion — rather than slow-acting oral iron tablets — should become standard pre-operative care, especially in settings where blood products are scarce or costly.
