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Iron replacement therapy in heart failure: a literature review
The Egyptian Heart Journal Pub Date : 2021-09-26 , DOI: 10.1186/s43044-021-00211-3
Hassan Ismahel 1 , Nadeen Ismahel 1
Affiliation  

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. 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.

中文翻译:

心力衰竭的铁替代疗法:文献综述

心力衰竭 (HF) 是一项重大的全球挑战,它被指定为 65 岁及以上人群住院的主要原因。无论贫血状态如何,大约一半的 HF 患者同时存在缺铁 (ID)。在 HF 中,与没有铁缺乏的患者相比,铁缺乏与较高的住院率和死亡率、较低的运动能力和较差的生活质量独立相关。由于这样的后果,一些研究调查了纠正 ID 是否可以改善 HF 结果。主体。截至 2021 年 6 月 1 日,七项随机对照试验探索了静脉 (IV) 铁在 HF 和 ID 患者中的使用,以及各种荟萃分析,包括个体患者数据荟萃分析,所有这些都在本综述中讨论. IV铁耐受性良好,不良事件发生率与安慰剂相当。在射血分数降低的心力衰竭 (HFrEF) 的情况下,IV 铁可降低因 HF 住院的风险,并改善纽约心脏协会 (NYHA) 的功能等级、生活质量和运动能力(根据 6 -分钟步行测试(6MWT))距离和峰值耗氧量。然而,静脉补铁对死亡率的影响尚不确定。最后,急性失代偿性心力衰竭或射血分数保留的心力衰竭 (HFpEF) 患者静脉补铁的证据有限。IV 铁可改善 HFrEF 和 ID 患者的某些结果。HFrEF 患者应筛查 ID,定义为铁蛋白 < 100 µg/L,或铁蛋白 100–299 µg/L,如果转铁蛋白饱和度 < 20%。如果发现 ID,应考虑静脉补铁,
更新日期:2021-09-28
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