Background:

The ACC/AHA heart failure (HF) guidelines include a class IIb recommendation for intravenous (IV) iron replacement in patients with iron deficiency and New York Heart Association class II or III to improve functional status and quality of life. Several studies have addressed the use of IV iron formulations such as ferric carboxymaltose or iron sucrose in HF population; however, few studies focused on sodium ferric gluconate complex (SFGC).

Objectives:

To assess the safety and effectiveness of an IV SFGC administration protocol in patients hospitalized with HF.

Methods:

A retrospective cohort study was conducted. We included patients admitted to the HF service from September 2017 to March 2018. The primary outcome was the frequency of adverse reactions. The secondary outcome was the odds of HF readmissions between the 2 groups (IV SFGC vs. control).

Results:

Of the 123 patients, 70 received IV iron (SFGC group) and 53 did not receive IV iron (control group). Five (7%) patients of the 70 in the SFGC group experienced adverse events, which included hypotension (n = 2, 2.8%), fever (n = 2, 2.8%) and myalgia (n = 2, 2.8%). Nine (12.8%) and 18 (25.7%) were readmitted within 30 days and 6 months respectively. In the control arm, 5 (9.4%) and 14 (26.4%) were admitted within 30 days and 6 months respectively. The odds of HF readmission at 30 days [OR 1.4 (95% CI: 0.45, 4.5)] and at 6 months [OR 0.96 (95% CI: 0.43, 2.2)] were similar in those who did not receive IV iron compared to those who received IV iron.

Conclusions:

Sodium ferric gluconate complex given at an accelerated dosing schedule appears to provide a more efficient means to prescribe IV iron in the inpatient setting and is safe with a low frequency of hypotension, fevers, and myalgias.

中文翻译：

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心力衰竭住院患者加速静脉铁剂给药方案的安全性和有效性

背景：

ACC/AHA 心力衰竭 (HF) 指南包括对缺铁患者进行静脉内 (IV) 补铁的 IIb 级建议和纽约心脏协会 II 级或 III 级以改善功能状态和生活质量。几项研究已经解决了在 HF 人群中使用 IV 铁制剂，如羧基麦芽糖铁或蔗糖铁；然而，很少有研究关注葡萄糖酸铁钠复合物（SFGC）。

目标：

评估 IV SFGC 给药方案对 HF 住院患者的安全性和有效性。

方法：

进行了一项回顾性队列研究。我们纳入了 2017 年 9 月至 2018 年 3 月期间接受 HF 服务的患者。主要结果是不良反应的频率。次要结果是 2 组之间 HF 再入院的几率（IV SFGC 与对照组）。

结果：

在 123 名患者中，70 人接受了静脉铁剂（SFGC 组），53 人未接受静脉铁剂（对照组）。SFGC 组 70 名患者中有 5 名 (7%) 出现不良事件，包括低血压 (n = 2, 2.8%)、发热 (n = 2, 2.8%) 和肌痛 (n = 2, 2.8%)。9 人（12.8%）和 18 人（25.7%）分别在 30 天和 6 个月内重新入院。在对照组中，分别有 5 人（9.4%）和 14 人（26.4%）在 30 天和 6 个月内入院。在 30 天 [OR 1.4 (95% CI: 0.45, 4.5)] 和 6 个月 [OR 0.96 (95% CI: 0.43, 2.2)] 与未接受静脉铁剂的患者相比，HF 再入院的几率相似。接受静脉铁剂的人。

结论：

以加速给药方案给予葡萄糖酸铁钠复合物似乎提供了一种更有效的方法，可以在住院环境中给予静脉铁剂，并且低血压、发热和肌痛发生率低是安全的。