Acute cardiac care & resuscitationRandomised controlled trial

Intravenous iron to treat anaemia before cardiac surgery (ITACS): international, double blind, placebo controlled randomised trial

BMJPublished

  • Randomised controlled trial
  • international
  • multicentre
  • double-blind
  • placebo-controlled
  • 33 hospitals across 10 countries

Authors' 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

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

OutcomeIntravenous ironPlaceboRR (95% CI)P value
Red cell transfusion during hospital stay61.1%68.2%0.90 (0.82–0.99)P = 0.027

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:10.1136/bmj-2026-100407

Summarised from the published abstract; every number is checked against it