Management and perceptions of anemia and iron deficiency prior to cardiac surgery

Introduction. Anaemia and iron deficiency (ID) are common in patients with cardiovascular disease and are associated with increased morbidity and mortality in cardiac surgery. However, no data are available on how this issue is addressed in Ibero-America. We therefore sought, under the auspices of the Inter-American Society of Cardiology, to explore the knowledge, attitudes, and practices of Latin American physicians involved in the perioperative care of patients undergoing cardiac surgery. Materials and methods. We conducted a cross-sectional study using an anonymous electronic survey distributed between January and August, 2025, through snowball sampling. Physicians engaged in clinical practice involving the care of patients prior to cardiac surgery were eligible for inclusion. Results. A total of 881 physicians from 23 countries responded. Although 83.7% reported routinely screening for anaemia, only 43.7% indicated that they assessed iron deficiency. Institutional protocols addressing this topic were reported by 18.2% of respondents. Marked heterogeneity was observed in therapeutic management: only 11.8% reported administering intravenous iron when anaemia or ID was diagnosed. While 46.9% of participants stated that they had routine access to intravenous iron, only 26.6% of these reported prescribing this intervention for patients in the preoperative cardiac surgery setting within the 6 months preceding the survey. Furthermore, 54.8% of respondents had not received specific training and felt only moderately prepared to manage these conditions. Conclusions. Our findings suggest substantial gaps between the available evidence and clinical practice in the preoperative management of anaemia and iron deficiency, underscoring the need for institutional protocols and enhanced specialised medical education.