Association Between Erythroferron and Perioperative Hemoglobin Levels in Patient Undergoing Heart Valve Surgery

Study Overview
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Brief Summary
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In patients undergoing cardiac surgery, perioperative anemia is an important factor in surgical recovery. In addition to the low preoperative hemoglobin level, the delayed recovery of the postoperative hemoglobin level is an important problem affecting the incidence of postoperative anemia. Erythroferron is the early response to of the red blood cell production in stressful situations such as anemia, bleeding, and hypoxia. Therefore, it is thought that acute blood loss and systemic inflammatory reaction that inevitably occurs after cardiac surgery will synthesize erythroferron, which helps to restore hemoglobin level at postoperative period by promoting hematopoiesis by simultaneously inhibiting hepcidin and activating hematopoiesis. In this study, the investigators will investigate the association between Erythroferron and perioperative hemoglobin levels in patient undergoing heart valve surgery.

Official Title
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Association Between Erythroferron and Perioperative Hemoglobin Levels in Patient Undergoing Heart Valve Surgery

Conditions
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Postoperative Anemia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than 20 years undergoing elective valvular heart surgery Exclusion Criteria: Emergency operation Co-operation with other surgeries Patients with cardiogenic shock or ventricular-assist device (eg. ECMO, IABP) Patients requiring mechanical ventilator care in preoperative period Patient with severe chronic kidney disease (GFR(CKD-EPI) <30ml/min/1.73m2) Patients with preoperative infection status (Eg. Sepsis) Patients with acute bleeding status Hemoglobin concentration below 10g/dL Disease directly affecting hematopoiesis (eg. Leukemia, myeloma, aplastic anemia) Uncompensated liver cirrhosis, acute hepatitis, alcoholics Patients who participated in other clinical studies that could affect prognosis Patients who cannot understand the informed consent (eg. Foreigner)

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Low Erythroferron group<br>The lower concentration group will be Group1. | |
| High Erythroferron group<br>The higher concentration group will be Group2. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of hemoglobin concentration level after surgery in patients undergoing heart valve surgery | Compare the change of hemoglobin concentration level after surgery in patients undergoing heart valve surgery, by dividing the groups according to the level of erythroferron immediately after surgery. The amount of change will be compared based on the lowest level of hemoglobin during the time point after surgery. Since investigators planed to compare the recovery rate as well as the amount of recovery at each time point, investigators planed to record the change of hemoglobin at each time point based on the lowest hemoglobin level after surgery. | at immediate after surgery, 1 day after surgery, 2 days after surgery(POD2), 7 days after surgery (POD7), first outpatient visit (up to 1 month after surgery) after discharge |