Studies have demonstrated there is a correlation between iron deficiency (ID) and clinical outcomes in patients with heart failure, regardless of whether or not they have ID anemia (IDA). Treatment of ID in heart failure has been investigated in a number of recent trials (including AFFIRM-AHF, IRONMAN, and HEART-FID), and their findings have led to guidelines recommendations for the use of ID and IDA screening and therapies in heart failure.
In heart failure patients the rate of ID and IDA screening and oral and intravenous (IV) iron supplementation therapies remains unclear. In a recent study, published in Circulation: Heart Failure, researchers utilized retrospective population health data from Alberta, Canada to examine the epidemiology of ID and IDA in patients with both acute (symptoms develop quickly) and chronic (symptoms develop gradually) heart failure, and also investigated the usage and frequency of iron supplementation in these settings.
This study used a combination of administrative, laboratory, and echocardiography data to identify all adult patients with heart failure living in Alberta between 2012 and 2019. Researchers found that among both acute and chronic heart failure patients, the rate of testing was low despite well-known associations with poor outcomes in heart failure and readily available testing and treatment options. In cases where patients were tested, ID and IDA were high in both acute and chronic heart failure patients, as well as across other heart failure subtypes. The study also established there was limited usage of oral and IV iron supplementation therapies within the patient population. Additionally, based on the eligibility criteria for the aforementioned AFFIRM-AHF, IRONMAN, and HEART-FID trials, it was found that IV iron therapy was not used for a significant portion of eligible patients.
Based on these results, the researchers emphasize the need for current practices to better meet the standards outlined in existing guideline recommendations. This current gap in care illustrates the importance of new and innovative strategies to improve both iron screening and therapy in patients with heart failure.
This research was co-authored by the CVC’s Muizz Wahid, MD (trainee); Sunjida Islam, MBBS, MSc; Nariman Sepehrvand, MD, PhD; Doug Dover, PhD; Finlay McAlister, MD, MSc; Padma Kaul, Phd; and Justin Ezekowitz, MBBCh, MS.
