Cardiothoracic & vascular anaesthesia
Intravenous iron to treat anaemia before cardiac surgery (ITACS): international, double blind, placebo controlled randomised trial
Errata to this article were published (BMJ, 3 Sep 2026 ↗ · 7 Sep 2026 ↗)
Primary result · Days alive and at home up to 90 daysResult — go to the resultAdjusted median difference 1.0 day 95.4% CI 0.0–2.1Authors' conclusion
Among patients with anaemia undergoing elective cardiac surgery, preoperative intravenous iron was associated with a reduction in red cell transfusion and a small improvement in the number of days alive and at home in the first 90 days after surgery.
Study context
- Population
- Adults with anaemia undergoing elective cardiac surgery921 assessed for primary outcome
- Participants
- 955 adults
- Comparison
- Preoperative intravenous iron vs placebo
- Primary endpoint
- Days alive and at home
- Follow-up
- Up to 90 days after surgery
Methodological detailsinternational, multicentre, double-blind, placebo-controlled, 33 hospitals across 10 countries
- International
- Multicentre
- Double-blind
- Placebo-controlled
- 33 hospitals across 10 countries
Primary result
Days alive and at home up to 90 days
Adjusted median difference
1.0 day
95.4% CI 0.0–2.1
P = 0.041
By group
Intravenous iron vs Placebo
adjusted median difference 1.0 day (95.4% CI 0.0–2.1); P = 0.041
As reported in the abstract
Secondary outcomes
| Outcome | Intravenous iron | Placebo | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Red cell transfusion during hospital stay | 61.1% | 68.2% | 0.90 (0.82–0.99) | P = 0.027 | |
| 0.512Relative risk (log scale) |
Major complications, length of hospital stay
- No differences observed
Original publication
Intravenous iron to treat anaemia before cardiac surgery (ITACS): international, double blind, placebo controlled randomised trial. BMJ. Published 19 August 2026. doi:10.
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