Heart Failure and Iron Deficiency Anemia in Italy: Results From CARMES-1 Registry

Caira, Carmen; Ansalone, Gerardo; Mancone, Massimo; Canali, Emanuele; Pagliaro, Michela; Fratarcangeli, Lara; Aznaran, Carlos Alberto Centurion; Gatto, Maria Chiara; Pietro, Riccardo Di; Fedele, Francesco

doi:10.2217/fca.13.12

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…Despite such guidelines we recently found that only 19.7% of patients admitted to our hospital with a primary diagnosis of HF had their iron parameters measured, yet in those in whom it was measured, 80% were found to be iron deficient [ 43 , 44 ]. A similar lack of investigation and treatment of ID in HF has been found by others [ 45 , 46 ].…”

Section: Official Recommendations For the Diagnosis And Treatment supporting

confidence: 72%

“…Non anemic iron deficiency is very common [ 121 , 122 ]. It may be a major cause of symptoms as shown above but is often missed [ 43 , 44 , 45 , 46 , 112 , 122 ]. Health personnel are apparently often not aware of the presence and importance of ID without anemia [ 122 ] and should be made aware of this very common entity.…”

Section: Lack Of Awareness Of the Importance On Non-anemic Iron Dmentioning

confidence: 99%

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Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

Silverberg

Wexler²,

Schwartz

2015

IJMS

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Anemia is present in about 40% of heart failure (HF) patients. Iron deficiency (ID) is present in about 60% of the patients with anemia (about 24% of all HF patients) and in about 40% of patients without anemia (about 24% of all HF patients). Thus ID is present in about half the patients with HF. The ID in HF is associated with reduced iron stores in the bone marrow and the heart. ID is an independent risk factor for severity and worsening of the HF. Correction of ID with intravenous (IV) iron usually corrects both the anemia and the ID. Currently used IV iron preparations are very safe and effective in treating the ID in HF whereas little information is available on the effectiveness of oral iron. In HF IV iron correction of ID is associated with improvement in functional status, exercise capacity, quality of life and, in some studies, improvement in rate of hospitalization for HF, cardiac structure and function, and renal function. Large long-term adequately-controlled intervention studies are needed to clarify the effect of IV iron in HF. Several heart associations suggest that ID should be routinely sought for in all HF patients and corrected if present. In this paper we present our approach to diagnosis and treatment of iron deficiency in heart failure.

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Section: Official Recommendations For the Diagnosis And Treatment supporting

confidence: 72%

Section: Lack Of Awareness Of the Importance On Non-anemic Iron Dmentioning

confidence: 99%

Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

Silverberg

Wexler²,

Schwartz

2015

IJMS

View full text Add to dashboard Cite

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“…Previous studies reported that 17-57% of patients admitted with HF had anemia (Horwich et al 2002;Ezekowitz et al 2003;Hamaguchi et al 2009;Caira et al 2013). In the present clinical study, the observed rate of anemia in consecutive HF patients admitted to the Cardiovascular Disease Department of Niigata University Medical and Dental Hospital was 41%, which agreed with the previous reports.…”

Section: Anemia and Hepcidin In Hf Patientssupporting

confidence: 92%

Liver Congestion in Heart Failure Contributes to Inappropriately Increased Serum Hepcidin despite Anemia

Ohno¹,

Hanawa²,

Jiao³

et al. 2015

Tohoku J. Exp. Med.

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Hepcidin is a key regulator of mammalian iron metabolism and mainly produced by the liver. Hepcidin excess causes iron deficiency and anemia by inhibiting iron absorption from the intestine and iron release from macrophage stores. Anemia is frequently complicated with heart failure. In heart failure patients, the most frequent histologic appearance of liver is congestion. However, it remains unclear whether liver congestion associated with heart failure influences hepcidin production, thereby contributing to anemia and functional iron deficiency. In this study, we investigated this relationship in clinical and basic studies. In clinical studies of consecutive heart failure patients (n = 320), anemia was a common comorbidity (41%). In heart failure patients without active infection and ongoing cancer (n = 30), log-serum hepcidin concentration of patients with liver congestion was higher than those without liver congestion (p = 0.0316). Moreover, in heart failure patients with liver congestion (n = 19), the anemia was associated with the higher serum hepcidin concentrations, which is a type of anemia characterized by induction of hepcidin. Subsequently, we produced a rat model of heart failure with liver congestion by injecting monocrotaline that causes pulmonary hypertension. The monocrotaline-treated rats displayed liver congestion with increase of hepcidin expression at 4 weeks after monocrotaline injection, followed by anemia and functional iron deficiency observed at 5 weeks. We conclude that liver congestion induces hepcidin production, which may result in anemia and functional iron deficiency in some patients with heart failure.

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“…These real word data, that confirm the results of our CARMES 1 study in a cohort of 418 hospitalized HF patients in Italy in which ID was underdiagnosed and undertreated [39] ( Figure 9), underline that diagnostic and therapeutic efforts on ID management in HF are still low in clinical practice.…”

Section: Iron Deficiency Anemiasupporting

confidence: 80%

Heart Failure and Iron Deficiency

Fedele¹,

Cinque²,

Mancone³

et al. 2019

Iron Deficiency Anemia

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Iron deficiency (ID) and iron deficiency anemia (IDA) are prevalent conditions all over the world. The groups at highest risk are children, pre-menopausal women and socially disadvantaged people. Diagnose of ID using a full blood examination and iron studies can be difficulted by concomitant inflammation. Management of ID involves identification and treatment of its cause, as well as effective iron replacement. Patients who fail to respond to iron replacement will performed an endoscopy to exclude internal bleeding. Both enteral and parenteral iron are effective at replacing iron. For adult patients, we recommend trialling daily oral iron (30-100 mg of iron) as the first-line therapy. Patients who fail to respond to oral iron replacement can be safely managed with intravenous iron.

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Heart Failure and Iron Deficiency Anemia in Italy: Results From CARMES-1 Registry

Cited by 10 publications

References 19 publications

Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

Liver Congestion in Heart Failure Contributes to Inappropriately Increased Serum Hepcidin despite Anemia

Heart Failure and Iron Deficiency

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