Iron test could improve outcomes for heart patients

Researchers at the University of Glasgow are investigating whether outcomes from heart surgery could be improved if patients were routinely tested and treated for iron deficiency.


It’s estimated that up to half of people who have heart surgery have iron deficiency, which can lead to increased blood transfusions, longer stays in intensive care and slower recovery. However, which blood test most accurately reflects iron deficiency is disputed.

Dr Pierpaolo Pellicori and his team, supported by the Glasgow Clinical Trial Unit directed by Professor John Cleland, have received British Heart Foundation (BHF) funding worth around £300,000 over three years to find out which is the best test for iron deficiency before heart surgery.

In their clinical trial, 500 people who are due to have heart surgery will have a panel of blood tests to check for iron deficiency. They will then be followed up after surgery to find out whether they needed more blood transfusions, how long they were in intensive care, and other clinical factors.

The blood results will be compared to the “gold-standard” test for iron deficiency, which is the amount of iron in the bone marrow (small fragments can be obtained during heart surgery). This will show which blood test or panel of tests is the best measure of iron deficiency.

The Glasgow researchers will also test whether giving an iron injection into a vein approximately one month before surgery gets to the bone marrow and corrects the iron deficiency  – a vital first step before a larger trial to conclusively test whether a “shot” of iron before heart surgery could reduce the risk of complications and hasten recovery.

Dr Pellicori explains: “Iron deficiency affects many people who need heart surgery and it is reasonable to believe this might increase the need for blood transfusions and slow down recovery. This BHF-funded study will assess which pre-operative blood test is best for detecting iron deficiency and whether giving intravenous iron before surgery corrects the problem. This lays the foundation for a larger trial to find out who will benefit from getting a shot of iron before heart surgery.”

James Jopling, Head of BHF Scotland, said: “We’re proud to be funding this innovative research at the University of Glasgow, but we urgently need help from the public during 2021 to enable us to keep funding future medical breakthroughs like these.

“There are currently around 700,000 people in Scotland living with heart and circulatory conditions, and Covid-19 has put many of them at greater risk than ever. But the effect of the virus has also cut our ability to fund new research in half. This is the toughest challenge we’ve faced in our 60-year history and we need help now more than ever to beat heartbreak forever.”

First published: 19 January 2021

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