Expert consensus on the importance of iron deficiency and the possibility of its correction in patients with heart failure
Authors:
prof. MUDr. Vojtěch Melenovský, CSc. 1; Miloš Táborský 2; Aleš Linhart 3; Jan Malík 4; Filip Málek 5; Radek Pudil 6; Jan Krejčí 7; Milan Šíranec 3
Authors‘ workplace:
Klinika kardiologie IKEM, Praha
1; I. interní klinika, Fakultní nemocnice Olomouc
2; II. interní klinika, Všeobecná fakultní nemocnice, Praha
3; III. interní klinika, Všeobecná fakultní nemocnice, Praha
4; kardiologické oddělení, Nemocnice Na Homolce, Praha
5; I. interní kardioangiologická klinika, Fakultní nemocnice Hradec Králové
6; I. interní kardioangiologická klinika, Fakultní nemocnice u sv. Anny, Brno
7
Published in:
Vnitř Lék 2021; 67(8): 495-497
Category:
Overview
Anemia and iron deficiency are common non-cardiovascular comorbidities of heart failure. The prevalence of iron deficiency is up to 55 % of patients with chronic heart failure and up to 80 % subjects with acute heart failure including acute decompensated heart failure, independently on anemia. The European Society of Cardiology Heart Failure Guidelines 2021 recommend intravenous iron replacement in patients with heart failure and iron deficiency to improve symptoms, stress tolerance and quality of life in chronic heart failure and to reduce risk of subsequent hospitalization after acute decompenstation.
Keywords:
Iron deficiency – heart failure – intravenous replacement
Sources
1. van der Meer P et al. Mitochondrial Function, Skeletal Muscle Metabolism, and Iron Deficiency in Heart Failure. Circulation. 2019; 139(21): 2399–2402.
2. Melenovsky V et al. Myocardial iron content and mitochondrial function in human heart failure: a direct tissue analysis. Eur J Heart Fail. 2017; 19(4): 522–530.
3. Van der Wal et al. EHJ 2019: 40, 3616–3625.
4. Lewis GD et al. Effect of Oral Iron Repletion on Exercise Capacity in Patients With Heart Failure With Reduced Ejection Fraction and Iron Deficiency: The IRONOUT HF Randomized Clinical Trial. JAMA. 2017; 317(19): 1958–1966.
5. SPC Ferinject: https://www.sukl.cz/modules/medication/detail.php?code=0192372 & tab=‑ texts
6. Anker SD et al. FAIR‑HF Trial: Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med. 2009; 361(25): 2436–2448.
7. Ponikowski P et al. CONFIRM‑HF Trial: Beneficial effects of long‑term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015 Mar 14; 36(11): 657–668.
8. Ponikowski P et al. AFFIRM‑AHF Trial: Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double‑blind, randomised, controlled trial. Lancet. 2020; 396(10266): 1895–1904.
9. Khan MS et al. Ferric carboxymaltose for the treatment of iron‑deficient heart failure patients: a systematic review and meta‑analysis. ESC Heart Fail. 2020; 7(6): 3392–3400.
10. Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016; 37(27): 2129–2200.
11. McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 doi: 10.1093/eurheartj/ehab368.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2021 Issue 8
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