Oral sucrosomial iron improves exercise capacity and quality of life in heart failure with reduced ejection fraction and iron deficiency: a non‐randomized, open‐label, proof‐of‐concept study

2021 ◽  
Author(s):  
Apostolos Karavidas ◽  
Efstratios Troganis ◽  
George Lazaros ◽  
Despina Balta ◽  
Ioannis‐Nektarios Karavidas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Iron Deficiency ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Proof Of Concept ◽  
Open Label ◽  
Reduced Ejection Fraction ◽  
Concept Study

scholarly journals Iron replacement therapy in heart failure: a literature review

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Hassan Ismahel ◽  
Nadeen Ismahel
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Iron Deficiency ◽  
Ejection Fraction ◽  
Exercise Capacity ◽  
Transferrin Saturation ◽  
Peak Oxygen Consumption ◽  
Main Body ◽  
Iv Iron

Abstract Background Heart failure (HF) is a major global challenge, emphasised by its designation as the leading cause of hospitalisation in those aged 65 and above. Approximately half of all patients with HF have concurrent iron deficiency (ID) regardless of anaemia status. In HF, iron deficiency is independently associated with higher rates of hospitalisation and death, lower exercise capacity, and poorer quality-of-life than in patients without iron deficiency. With such consequences, several studies have investigated whether correcting ID can improve HF outcomes. Main body. As of 1st June 2021, seven randomised controlled trials have explored the use of intravenous (IV) iron in patients with HF and ID, along with various meta-analyses including an individual patient data meta-analysis, all of which are discussed in this review. IV iron was well tolerated, with a comparable frequency of adverse events to placebo. In the context of heart failure with reduced ejection fraction (HFrEF), IV iron reduces the risk of hospitalisation for HF, and improves New York Heart Association (NYHA) functional class, quality-of-life, and exercise capacity (as measured by 6-min walk test (6MWT)) distance and peak oxygen consumption. However, the effect of IV iron on mortality is uncertain. Finally, the evidence for IV iron in patients with acute decompensated heart failure, or heart failure with preserved ejection fraction (HFpEF) is limited. Conclusions IV iron improves some outcomes in patients with HFrEF and ID. Patients with HFrEF should be screened for ID, defined as ferritin < 100 µg/L, or ferritin 100–299 µg/L if transferrin saturation < 20%. If ID is found, IV iron should be considered, although causes of ID other than HF must not be overlooked.

Co-morbidity (HFrEF and HFpEF): anaemia/iron deficiency

ESC CardioMed ◽  
2018 ◽  
pp. 1816-1822
Author(s):  
Michal Tkaczyszyn ◽  
Ewa A. Jankowska ◽  
Piotr Ponikowski
Keyword(s):  
Quality Of Life ◽  
Iron Deficiency ◽  
Exercise Capacity ◽  
Ferric Carboxymaltose ◽  
Mortality And Morbidity ◽  
Reduced Ejection Fraction ◽  
Co Morbidity ◽  
Poor Outcomes ◽  
Improve Exercise Capacity

Anaemia is a frequent co-morbidity in patients with heart failure (HF), its prevalence increases with disease severity, and it is associated with poor outcomes. The aetiology of anaemia in HF is multifactorial, with the following common underlying causes: gastrointestinal bleeding, renal dysfunction, haemodilution, haematinic deficiencies, deranged steroid metabolism, bone marrow dysfunction and iron deficiency (ID). Erythropoiesis-stimulating agents to correct anaemia in HF did not improve mortality and raised safety concerns, thus are not recommended in these patients. ID in HF has been traditionally linked with anaemia; however, recent studies report a high prevalence also in non-anaemic patients and independent adverse clinical and prognostic consequences (decreased exercise capacity, poor quality of life, and higher mortality) of this co-morbidity. A number of studies have demonstrated that ID can be safely corrected with intravenous iron (ferric carboxymaltose) with symptomatic improvement. According to the recent European Society of Cardiology Guidelines, active screening for the presence of ID is recommended in all HF patients, and in symptomatic HF patients with reduced ejection fraction and with ID, intravenous ferric carboxymaltose should be considered to alleviate symptoms, and improve exercise capacity and quality of life. Ongoing trials are investigating the effect of ID correction on mortality and morbidity.

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