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ImmunoAnalysis. 2024;4: 3.
doi: 10.34172/ia.4051
  Abstract View: 49
  PDF Download: 23

Original Research

Effect of ferric carboxymaltose in the iron deficiency anemia patients undergoing cardiac surgery: A randomized clinical trial

Fateme Ramezani 1 ORCID logo, Elham Khalaf Adeli 2, Karim Shamsasanjan 1* ORCID logo, Ali Zahed Mehr 3, Mostafa Alavi 4, Hooman Bakhshandeh 5, Saeid Hosseini 6, Alireza Alizadeh-Ghavidel 6, Ali Akbar Pourfathollah 7

1 Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
3 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran
4 Cardiac Anesthesia Department, Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran
5 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
6 Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
7 Departments of Immunology, Faculty of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran
*Corresponding Author: Karim Shamsasanjan, Email: shamsk@tbzmed.ac.ir

Abstract

Background: Iron deficiency is frequent in patients undergoing cardiac surgery. Intravenous iron agents have been used for treating patients with iron deficiency anemia. The present study aimed to investigate the efficacy of ferric carboxymaltose (FCM) among the iron deficiency anemia patient candidates for cardiac surgery.

Methods: The present non-blinded, randomized, controlled clinical study was performed among two groups of the iron deficiency anemia patients underwent cardiac surgery. The first of whom was infused with a fixed dose of 1000 mg FCM, 3-5 weeks preoperatively, while the second group received no medicine (control). The changes in hemoglobin concentration and biomarkers of iron metabolism were repeated before surgery and 3 to 5 days after surgery. Moreover, the average number of consumed packed cells was assessed.

Results: In this study, clinical tests, demographic characteristics, and surgery type were similar in two groups. Regarding hemoglobin (Hb) level, a significant difference was demonstrated between FCM-administered group in the preoperative stage (12.1 g/dL, 11.6-12.9) and the control (11.5 g/dL, 10.9-11.8) (P<0.001). Additionally, the preoperative serum ferritin level of FCM group was determined 580 ng/dL (435-787) which significantly differed from that of the control (57 ng/dL, 32-100) (P=0.001).

Conclusion: The use of FCM is ineffective for preoperative anemia correction in the patients undergoing cardiac surgery and fails to decrease transfusion during surgery in spite of improvement in in iron stores.

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Submitted: 18 May 2023
Accepted: 24 Feb 2024
ePublished: 30 May 2024
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