Iron Therapy in Patients With Heart Failure and Iron Deficiency

Review of Iron Preparations for Practitioners

Marcin Drozd; Ewa A. Jankowska; Waldemar Banasiak; Piotr Ponikowski


Am J Cardiovasc Drugs. 2017;17(3):183-201. 

In This Article

Prevalence of ID in HF

ID constitutes a frequent co-morbidity in patients with HF, and its prevalence varies according to the clinical characteristics of the studied cohort and the applied definition of ID. Based on laboratory tests (the only study investigating ID in HF based on bone marrow aspirates is presented in Table 1 ), the prevalence of ID in HF ranges from 33 to 74%,[14,23,24,26,45–53] with higher rates in anaemics versus non-anaemics[14,23,24,26,45,48,49] and decompensated[26,52,54,55] versus stable HF[14,23,24,45–51,53,56–58] ( Table 1 ).

The majority of data on the prevalence of ID in HF comes from European HFrEF cohorts;[14,24,48,50,56] however, the limited data on patients with both reduced and preserved left ventricle ejection fraction (HFpEF) show similar percentages of iron-deficient enrollees.[23,46] Importantly, in one study involving a multi-ethnic Southeast Asian population of patients with HF, the prevalence of ID was higher than in European cohorts.[23,26,49,55] The gender differentiation has been shown in one study with patients with decompensation of chronic HF,[55] where the prevalence of ID was 69% in men and 75% in women, and in one study in chronic stable HF where the prevalence of ID was 32% in men and 54% in women.[24] Besides anaemia,[23,24] the higher prevalence of ID in patients with HF correlates with female sex,[23,24] more advanced HF symptoms [higher New York Heart Association functional classification (NYHA) class],[23,24] neurohormonal activation [higher N-terminal pro-brain natriuretic peptide (NT-proBNP)],[23,24] and inflammation (higher high-sensitivity C-reactive protein).[24]