Iron deficiency in chronic heart failure: An international pooled analysis

Klip, IJsbrand T.; Comín‐Colet, Josep; Voors, Adriaan A.; Ponikowski, Piotr; Enjuanes, Cristina; Banasiak, Waldemar; Lok, Dirk J.; Rosentryt, Piotr; Torrens, Ainhoa; Poloński, Lech; Veldhuisen, Dirk J. van; Meer, Peter van der; Jankowska, Ewa A.

doi:10.1016/j.ahj.2013.01.017

Cited by 594 publications

(688 citation statements)

References 38 publications

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“…It does not appear to correlate with function capacity or LV stiffness 235. A pooled analysis in a mixed population of HFpEF and HFrEF patients found that iron deficiency without anemia portends a worse prognosis than anemia without iron deficiency 236. From a therapeutic standpoint treatment with erythropoietin alpha does not improve functional capacity or reduce LV mass in elderly HFpEF patients 237…”

Section: Comorbid Conditionsmentioning

confidence: 99%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

109

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Section: Comorbid Conditionsmentioning

confidence: 99%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

109

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“…Prevalence rates of iron deficiency (ID) in Southeast Asian HF patients also exceed those in European patients, averaging 61% and peaking at 80% in patients of Indian ethnicity 3. Regardless of ethnicity, geographical location, and anaemia status, concurrent HF and ID has consistently been associated with poor outcomes such as reduced exercise capacity, reduced quality of life (QoL), and elevated risks of HF hospitalization and mortality 4, 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

Single‐dose intravenous iron in Southeast Asian heart failure patients: A pilot randomized placebo‐controlled study (PRACTICE‐ASIA‐HF)

Yeo

Hadi³

et al. 2018

ESC Heart Failure

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AimsIron deficiency is highly prevalent in Southeast Asians with heart failure (HF) and associated with worse outcomes. This trial aimed to assess the effect of intravenous iron in Southeast Asians hospitalized with decompensated HF.Methods and resultsFifty patients hospitalized for acute decompensated HF, regardless of ejection fraction, with iron deficiency (defined as serum ferritin <300 ng/mL if transferrin saturation is <20%) were randomized to receive either one dose of intravenous ferric carboxymaltose (FCM) 1000 mg or placebo (0.9% saline) following HF stabilization and before discharge in two Singapore tertiary centres. The primary endpoint was difference in 6‐min walk test (6MWT) distance over 12 weeks, while secondary endpoints were quality of life assessed using validated Kansas City Cardiomyopathy Questionnaire (KCCQ) and Visual Analogue Scale (VAS). Improvement in 6MWT distance at Week 12 was observed in both FCM and placebo groups (from 252 ± 123 to 334 ± 128 m and from 243 ± 67 to 301 ± 83 m, respectively). Unadjusted analysis showed 6MWT distance for FCM exceeded that for placebo, but adjustment for baseline covariates and time attenuated this effect {adjusted mean difference between groups: 0.88 m [95% confidence interval (CI) −30.2 to 32.0, P = 0.956]}. KCCQ overall summary and VAS were similar in both groups [adjusted mean difference: KCCQ −1.48 (95% CI −8.27 to 5.31, P = 0.670) and VAS 0.26 (95% CI −0.33 to 0.86, P = 0.386)]. FCM was well tolerated with no serious treatment‐related adverse events.ConclusionsIntravenous FCM administered pre‐discharge in Southeast Asians hospitalized with decompensated HF is clinically feasible. Changes in 6MWT distance should be measured beyond Week 12 to account for background therapy effects.

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“…Approximately 50% of patients with CHF are iron deficient 12, 13, 14. Iron deficiency (ID) is defined as a ferritin level <100 μg/L or ferritin 100–299 μg/L with a transferrin saturation <20% 12.…”

Section: Introductionmentioning

confidence: 99%

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

Theidel¹,

Väätäinen

Martikainen

et al. 2017

ESC Heart Failure

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AimsTreatment of iron deficiency (ID) in patients with heart failure (HF) with intravenous iron substitution [ferric carboxymaltose (FCM)] has previously shown significant improvements in exercise capacity, New York Heart Association (NYHA) functional class, quality of life, and reduction of hospitalization. The aim of this study was to estimate the budget impact of FCM treatment for patients with HF and ID.Methods and resultsIndividual patient data from four double‐blind randomized controlled trials were pooled for this analysis. Expected outcomes were modelled for a treatment period of 1 year, using multivariate statistical methods. Associated unit costs were derived from claims data. Budget impact was calculated from the perspective of the Statutory Health Insurance. Multiple deterministic sensitivity analyses were performed. The annual budget impact for therapy with FCM vs. no‐iron therapy was €2 735 505 and €2 695 474 for 1000 patients, respectively, resulting in additional annual costs of €40.03 for each treated patient. Main costs drivers are the FCM treatment cost and cost of hospitalizations due to HF worsening. FCM therapy compared with no‐iron therapy resulted in reduced cost per 1000 patients: for reduced hospitalization due to HF worsening (52 vs. 129 hospitalizations amounting to €230 591 vs. €597 078), for reduced other medication (€1 611 007 vs. €1 679 908), fewer outpatient visits (€332 523 vs. €378 019), and home visits (€29 627 vs. €40 469). Sensitivity analyses showed robustness of the results.ConclusionsTherapy with FCM has a minimal budget impact of €40 031 per 1000 patients per year. This budget impact translates into reduced and shorter hospitalizations and improved symptomatic status of the patients.

show abstract

Iron deficiency in chronic heart failure: An international pooled analysis

Abstract: Iron deficiency is common in patients with chronic HF, relates to disease severity, and is a strong and independent predictor of outcome. In this study, ID appears to have greater predictive power than anemia.

Cited by 594 publications

References 38 publications

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Single‐dose intravenous iron in Southeast Asian heart failure patients: A pilot randomized placebo‐controlled study (PRACTICE‐ASIA‐HF)

Budget impact of intravenous iron therapy with ferric carboxymaltose in patients with chronic heart failure and iron deficiency in Germany

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