Management of iron deficiency in chronic heart failure
Iron deficiency is frequent in patients with chronic heart failure (CHF) with a prevalence of 50%, and its frequency varies depending on the study groups. The presence of iron deficiency limits erythropoiesis, leading to the development of anemia over time in patients with CHF, regardless of gender,...
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| Format: | Article |
| Language: | Russian |
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"Consilium Medicum" Publishing house
2022-05-01
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| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/108242/81796 |
| _version_ | 1818208214763700224 |
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| author | Tatiana M. Uskach |
| author_facet | Tatiana M. Uskach |
| author_sort | Tatiana M. Uskach |
| collection | DOAJ |
| description | Iron deficiency is frequent in patients with chronic heart failure (CHF) with a prevalence of 50%, and its frequency varies depending on the study groups. The presence of iron deficiency limits erythropoiesis, leading to the development of anemia over time in patients with CHF, regardless of gender, race, and left ventricular ejection fraction (LVEF). Observational studies demonstrate a higher prevalence of iron deficiency in women and in patients with higher NYHA (New York Heart Association) functional class, decreased LVEF, increased brain natriuretic peptide (NT-proBNP), or increased high-sensitivity C-reactive protein. Iron deficiency and anemia in patients with CHF are independently associated with a decreased exercise capacity, hospitalizations for CHF, an increase in overall mortality and mortality from cardiovascular diseases. The clinical significance of iron deficiency requires the need to diagnose iron metabolism in all patients with CHF. Current guidelines for the diagnosis and treatment of CHF indicate the need to determine the level of ferritin and saturation of transferrin in all patients with a suspected diagnosis of heart failure. The use of oral iron therapy in patients with CHF demonstrates its low efficacy in correcting this condition according to the clinical trials. At the same time the use of intravenous iron therapy is safe and improves symptoms, exercise capacity and quality of life in patients with heart failure with reduced ejection fraction and iron deficiency, which has been shown both in international placebo-controlled trials and meta-analyses. The use of iron carboxymaltose should improve CHF symptoms, exercise capacity and quality of life in patients with CHF and LVEF45%. Intravenous iron therapy has also been shown to reduce readmissions for CHF in patients with an LVEF50% who have recently been hospitalized for worsening CHF. |
| first_indexed | 2024-12-12T04:41:16Z |
| format | Article |
| id | doaj.art-f09cd6e4221b46c2b051ed411e51e6eb |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-12-12T04:41:16Z |
| publishDate | 2022-05-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-f09cd6e4221b46c2b051ed411e51e6eb2022-12-22T00:37:49Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422022-05-0194457257810.26442/00403660.2022.04.20145178106Management of iron deficiency in chronic heart failureTatiana M. Uskach0https://orcid.org/0000-0003-4318-0315Chazov National Medical Research Center of CardiologyIron deficiency is frequent in patients with chronic heart failure (CHF) with a prevalence of 50%, and its frequency varies depending on the study groups. The presence of iron deficiency limits erythropoiesis, leading to the development of anemia over time in patients with CHF, regardless of gender, race, and left ventricular ejection fraction (LVEF). Observational studies demonstrate a higher prevalence of iron deficiency in women and in patients with higher NYHA (New York Heart Association) functional class, decreased LVEF, increased brain natriuretic peptide (NT-proBNP), or increased high-sensitivity C-reactive protein. Iron deficiency and anemia in patients with CHF are independently associated with a decreased exercise capacity, hospitalizations for CHF, an increase in overall mortality and mortality from cardiovascular diseases. The clinical significance of iron deficiency requires the need to diagnose iron metabolism in all patients with CHF. Current guidelines for the diagnosis and treatment of CHF indicate the need to determine the level of ferritin and saturation of transferrin in all patients with a suspected diagnosis of heart failure. The use of oral iron therapy in patients with CHF demonstrates its low efficacy in correcting this condition according to the clinical trials. At the same time the use of intravenous iron therapy is safe and improves symptoms, exercise capacity and quality of life in patients with heart failure with reduced ejection fraction and iron deficiency, which has been shown both in international placebo-controlled trials and meta-analyses. The use of iron carboxymaltose should improve CHF symptoms, exercise capacity and quality of life in patients with CHF and LVEF45%. Intravenous iron therapy has also been shown to reduce readmissions for CHF in patients with an LVEF50% who have recently been hospitalized for worsening CHF.https://ter-arkhiv.ru/0040-3660/article/viewFile/108242/81796heart failureiron deficiencyintravenous iron therapy |
| spellingShingle | Tatiana M. Uskach Management of iron deficiency in chronic heart failure Терапевтический архив heart failure iron deficiency intravenous iron therapy |
| title | Management of iron deficiency in chronic heart failure |
| title_full | Management of iron deficiency in chronic heart failure |
| title_fullStr | Management of iron deficiency in chronic heart failure |
| title_full_unstemmed | Management of iron deficiency in chronic heart failure |
| title_short | Management of iron deficiency in chronic heart failure |
| title_sort | management of iron deficiency in chronic heart failure |
| topic | heart failure iron deficiency intravenous iron therapy |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/108242/81796 |
| work_keys_str_mv | AT tatianamuskach managementofirondeficiencyinchronicheartfailure |