Effect of Non-anemic Iron Deficiency on Outcome Following Off-pump Coronary Revascularization

Yonsei University433 enrolled

Overview

This is a single center retrospective study of patients who underwent off pump coronary artery bypass surgery between 2016.11\~2023.05. From this patient group, preoperatively non-anemic patients were selected and were divided into 2 cohorts according to their preoperative iron status; iron replete and iron deficient. These two cohorts were compared to evaluate the effect of preoperative iron deficiency on patient outcomes. The primary end point was the occurrence of composite morbidity/mortality end points which were: in hospital mortality, acute kidney injury (AKI), stroke, deep sternal infection, hemostatic reoperation, prolonged mechanical ventilation of more than 24hours, delirium and postoperative myocardial infarction. Occurrence of any one of these outcomes counted as primary end point met. Secondary outcome was to evaluate and compare hemoglobin recovery of iron replete and deficient patients until one year after surgery.

Study Type

OBSERVATIONAL

Enrollment

433

Conditions

Coronary Artery Bypass, Off-Pump Iron Deficiencies

Eligibility

Sex: ALLMin age: 29 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who received off pump coronary artery bypass surgery (OPCAB) between 2016.11.01-2023.05.31 Exclusion Criteria: * preoperative anemia (male Hb \<13g/dL, female Hb\<12g/dL) * emergency surgery * redo-off pump coronary artery bypass surgery * minimally invasive coronary artery bypass surgery * OPCAB in conjunction with other cardiac surgical procedures (e.g. valve surgery, graft replacement surgery of the aorta) * intraoperative on pump conversion * lack of sufficient preoperative data (ferritin, transferrin saturation, C-reactive protein) to determine iron status * administration of intravenous iron within 4 weeks or parenteral iron of more than 2 weeks prior to surgery * enrollemnt in other clinical studies

Outcomes

Primary Outcomes

Number of participants with in hospital mortality, stroke, deep sternal infection, hemostatic reoperation, delirium

This outcome is a composite of the following: in hospital mortality, acute kidney injury (AKI), stroke, deep sternal infection, hemostatic reoperation, prolonged mechanical ventilation of more than 24hours, delirium and postoperative myocardial infarction. The occurrence of any one of these was regarded as primary end point met.

Time frame: from the end of surgery until patient discharge (assessed up to day 60)

Number of participants with acute kidney injury

Time frame: until 7 days after surgery

Number of participants with post operative myocardial infarction

Time frame: until 48 hours post-surgery

Secondary Outcomes

Post discharge hemoglobin

Data of hemoglobin levels after discharge until 1 year after surgery was collected to evaluate hemoglobin recovery to preoperative baseline levels.

Time frame: Until 1 year after surgery