CORRECTION OF IRON DEFICIENCY IN PATIENTS WITH CHF: UPDATE OF PRACTICAL RECOMMENDATIONS

Abstract. The European Society of Cardiology considers iron deficiency as a common comorbid condition in chronic heart failure (CHF) and provides recommendations for its diagnosis and treatment. Nevertheless, in clinical practice, even in developed countries, iron deficiency remains unnoticed by clinicians, and many patients with CHF do not receive replacement therapy, which can positively affect the functioning of the cardiovascular system and well-being. Therefore, in 2018, an international working group developed special recommendations for screening and correction of iron deficiency in this category of patients.

Keywords: iron deficiency, chronic heart failure, Sufer.

Authors:

Voronkov L.G.

Literature:

  1. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: TheTask Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891–975.
  2. McDonagh T., et al. Screening, diagnosis and treatment of iron deficiency in chronic heart failure: putting the 2016 European Society of Cardiology heart failure guidelines into clinical practice. European Journal of Heart Failure. 2018;20: 1664–1672. doi:10.1002/ejhf.1305.
  3. Klip I.T., Comin-Colet J., Voors A.A.,et al. Iron deficiency in chronic heart failure: an international pooled analysis. AmHeart J. 2013;165:575–582.e3.
  4. von Haehling S., Gremmler U., Krumm M., et al. Prevalence and clinical impact of irondeficiency and anaemia among out patients with chronic heart failure: The PrEPRegistry. ClinResCardiol. 2017;106:436–443.
  5. McDonagh T., Macdougall I.C. Iron therapy for the treatment of irondeficiency in chronic heart failure: intravenousororal? Eur J HeartFail. 2015;17:248–262.
  6. Lewis G.D., Malhotra R., Hernandez A.F., et al. Effect of oral iron repletion on exercise capacity in patients with heart failure with reduce dejection fraction and iron deficiency: the IRONOUT HF randomized clinical trial. JAMA. 2017;317:1958–1966.
  7. Anker S.D., Comin Colet J., Filippatos G., Willenheimer R., Dickstein K., Drexler H., Luscher T.F., Bart B., Banasiak W., Niegowska J., Kirwan B.A., Mori C., von EisenhartRothe B., Pocock S.J., Poole-Wilson P.A., Ponikowski P.; FAIR-HF Trial Investigators. Ferric carboxymaltose in patients with heart failure and iron defciency. N Engl J Med. 2009;361:2436–2448.
  8. Okonko D.O., Grzeslo A., Witkowski T., et al. Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency. FERRIC-HF: a randomized, controlled, observer-blinded trial. J Am CollCardiol. 2008;51:103–112.
  9. Ponikowski P., van Veldhuisen D.J., Comin-Colet J., Ertl G., Komajda M., Mareev V., McDonagh T., Parkhomenko A., Tavazzi L., Levesque V., Mori C., Roubert B., Filippatos G., Ruschitzka F., Anker S.D.; CONFIRM-HF Investigators. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015;36:657–668.
  10. Toblli J.E., Lombrana A., Duarte P., Di Gennaro F. Intravenous iron reduces NT-pro-brain natriuretic peptide in anemic patients with chronic heart failure and renal insuffciency. J Am CollCardiol. 2007;50:1657–1665.
  11. Beck-da-Silva L., Piardi D., Soder S., et al. IRON-HF study: a randomized trial to assess the effects of iron in heart failure patients with anemia. Int J Cardiol. 2013;168:3439–3442.
  12. Jankowska E.A., Tkaczyszyn M., Suchocki T., et al. Effects of intravenous iron therapy in iron-defcient patients with systolic heart failure: a meta-analysis of randomized controlled trials. Eur J Heart Fail. 2016;18:786–795.