Anaemia, Cardiac Patients, Iron Deficiency, Vascular Patients
Conditions
Brief summary
CAVIAR is a multicentre prospective observational study. Centres for cardiac and vascular surgery assess and manage patients in different ways before surgery. Some centres have introduced the use of intravenous iron therapy for patients with anaemia in the preoperative setting. Consequently regional variation exists in the assessment and management of patients before cardiac and vascular surgery. We aim to observe and measure these differing pathways and observe if there is variation in iron deficiency and anaemia and the impact of these variables on patient cardiorespiratory function as well as post-operative outcomes. \[Sub-Study\] For patients who are receiving intravenous iron therapy as part of their routine clinical care, we wish to observe this effect in more detail. We will assess the impact of the treatment on well-being, blood count and fitness. Information will be collected through Quality of Life questionnaires, total haemoglobin mass test (via blood collection) and fitness testing.
Interventions
Sponsors
University College, London
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Male and female adults aged 18 years or older 2. Screening \[Hb\] \< 120 g/L (for females) or \< 130g/L (for males) 3. Undergoing elective cardiac OR vascular surgery: * Coronary artery bypass (CABG), or valvular surgery, or combined CABG and valve surgery. * Repair or replacement of thoracic or abdominal aorta (open or endovascular). 4. Able to provide informed consent 5. (if applicable) Able to perform CPET or 6MWT if consented to take part in the sub study
Exclusion criteria
1. Pregnancy or lactation 2. Adults with known underlying history of learning disabilities, or adults who do not have mental capacity to consent for themselves 3. Prisoners 4. Renal dialysis (current or planned within the next 12 months)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in Haemoglobin | From baseline to before surgery (within 10-42 days) |
Secondary
| Measure | Time frame |
|---|---|
| Changes in biomarkers of iron deficiency (e.g. hepcidin, ferritin, TfSats) | From baseline to after IV iron (within 4-6 weeks before surgery) |
| Haemoglobin | Before surgery (within 10-42 days) to post surgery (within 3 weeks) |
| Unit of blood transfused | Hospital stay (within 7 days) |
| ICU and hospital length of stay | Within 30 days |
| Feasibility - number of successful patient recruitment and consent | Within a year |
| Complications | Within 30 days post surgery |
| Total haemoglobin mass test (Sub-study ONLY) | From baseline to after IV iron (within 4-6 weeks before surgery) |
| Functional exercise testing (CPET or 6MWT) (Sub-study ONLY) | From baseline to after IV iron (within 4-6 weeks before surgery) |
| Quality of Life (Sub-Study ONLY) | From baseline to i) after IV iron (within 4-6 weeks before surgery), ii) post surgery (within 3 weeks) |
| Renal function (change in creatinine) | From baseline to before surgery (within 10-42 days) |
Outcome results
None listed