Approaches to the treatment of anaemia in patients with chronic heart failure

Prevalence and Treatment of Iron Deficiency Anemia in Patients with Chronic Heart Failure

“…A previous study found IDA in 21% of patients. That study used different criteria to diagnose IDA (i.e., ferritin <30 ng/ml and iron saturation <16%) [5].…”

“…IDA is more prevalent in young women (9%-11%), because its prevalence decreases to 5%-7% after menopause [4]. The prevalence of anemia in heart failure patients is 50%-60%, according to the OPTIME-HF trial; IDA constitutes 21% of all cases of anemia in heart failure patients [5]. A previous study showed that 25% of all patients with severe heart failure develop anemia with a hemoglobin less than 12 mg/dl [1] various etiologies, including sodium or water retention, have been proposed as an underlying cause of anemia in patients with cardiac dysfunction; these etiologies are reported to cause hemodilution, decreased iron absorption, impaired iron metabolism, and increased inflammatory factors (e.g., IL-1, IL-6 and TNF) that cause a decrease in erythropoietin production [1].…”

“…Nutritional causes (e.g., folic acid deficiency and use of either aspirin or warfarin with subsequent gastrointestinal bleeding), may contribute to the development of anemia in heart failure patients [5]. Treatment of the underlying anemia in heart failure patients improves both symptoms and prognosis and decreases both medical costs and morbidity [1].…”

“…For every 1 gram increase in hemoglobin there is a 13% decrease in the morbidity and mortality rate of heart failure [1]. Treatment of IDA in heart failure patients improves exercise tolerance and oxygen consumption in those patients [5]. Due to both the importance of optimal management of patients with underlying heart failure and the controversy surrounding treating anemia in patients with a decreased ejection fraction, we studied the effect of treating a patient's underlying anemia by measuring echo-cardiographic parameters and clinical responses.…”

Deficiência de ferro na insuficiência cardíaca

“…18 A deficiência de ferro (Fe) é uma causa importante em pacientes com insuficiência cardíaca e apresenta múltiplas causas, como ingestão deficiente deste elemento, má absorção devido ao edema da alças intestinais, perda sanguínea pelo trato gastrintestinal causada por medicações anticoagulantes e antiplaquetárias, gastrites urêmicas e alteração no transporte de Fe causado pelo aumento da atividade de citocinas. 19 A prevalência da anemia ferropriva na IC varia entre os estudos e isto depende do método usado para diagnóstico. Nanas et al investigaram causas de anemia e, utilizando como método a aspiração e coloração de medula óssea, encontraram deficiência de ferro em 73% dos 37 pacientes hospitalizados com IC avançada.…”