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Role of IV Iron Beyond Anemia and Hemoglobin in Heart Failure

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Dr Prasant Kr Sahoo, Bhubaneswar    19 December 2017

Iron is a metabolically active micronutrient with a multitude of effects on the body’s metabolism. It can act as a cofactor for enzymes and a catalyst for biochemical reactions, and is essential for blood cell production.

While the treatment of anemia with erythropoiesis-stimulating agents in patients with HF has failed to show a benefit in terms of morbidity and mortality, treatment with IV iron in patients with HF and reduced ejection fraction and iron deficiency is associated with clinical improvement. Thus, iron therapy can also improve physical functioning in HF patients with iron deficiency. Iron therapy has been found to improve kidney function in patients with HF and iron deficiency.

EFFECT-HF demonstrated that treatment with IV ferric carboxymaltose provided a significantly beneficial effect on peak VO2 compared with the control group. The EFFECT-HF study results confirm and extend upon the findings of the FAIR-HF and CONFIRM-HF studies, which also demonstrated that treatment with IV ferric carboxymaltose was associated with improvements in functional capacity and symptoms, in patients with CHF and iron deficiency.

Ferric carboxymaltose is likely to be the preferred option for most patients requiring parenteral iron supplementation as it can provide a higher dose of non-dextran iron that can be administered in a shorter timeframe.

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