A comparative study regarding oral and intravenous iron treatment in patients with heart failure

Introduction: The current ESC heart failure guideline recommends the use of Ferric Carboxymaltose for the treatment of iron deficiency associated with heart fai-lure. In practice, however, we are faced with the need for more affordable preparations, for example oral pre-parations.

Objective: We started evaluating the efficacy of oral iron compared to intravenous iron, with an impact on the decision to use in the extra-hospital chronic treat-ment.

Methods: T his prospective, observational study, part of a doctoral research, included 129 consecutive pati-ents admitted to the Medical Clinic II of St. Spiridon Iasi Hospital who had heart failure and iron deficiency (ferritin <100 μg/l or 100-300 μg/l with transferrin sa-turation <20%). The patients were treated with oral or intravenous iron for 6 months and were clinically, bio-logically, echocardiographically evaluated. The patients completed the Kansas City Cardiomyopathy Question-naire and performed the 6-minute walk test at the be-ginning and end of the study.

Results: Patients undergoing intravenous iron experi-enced a statistically significant increase in hemoglobin (p=0.018), ferritin (p=0.016) and an improvement in left ventricular dimensions evaluated by echocardiogra-phy: left ventricular telediastolic diameter (p=0.019), interventricular septum (p=0.038). The quality of life was significantly improved in this category of patients (p<0.001) as well as the exercise capacity assessed by the 6 minute walk test (p=0.042). Patients treated with oral iron had no statistically significant increase in hemoglobin (p=0.164), but ferritin values (p=0.008), left ventricle parameters: posterior wall (p=0.006) and ejection fraction (p=0.014) were statisticaly increased. Also, were observed improvement in the NYHA class of cardiac failure (p=0.031), the quality of life (p<0.001) and the walking test (p=0.005).

Conclusions: T he present research brings important elements to determine the potential beneficial role of oral iron preparations on echocardiographic parame-ters and quality of life in patients with heart failure. The lack of statistical significance for the increase in hemo-globin can be explained by the limited number of patients included. The mechanism of these benefits may be the recovery of cardiac and muscle reserve secondary to treatment.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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