Long-Term Effect of Intravenous Iron on Overall Survival and Hospitalization in Patients with Heart Failure with Reduced Ejection Fraction, Iron Deficiency and Mild Renal Impairment: An Open-Label 5-Year Follow Up Observation OC18-OC24
Dr. Jorge Eduardo Toblli,
Hospital Alemán, School of Medicine, University of Buenos Aires,
Av. Pueyrredon 1640, (1118) Buenos Aires, Argentina.
Introduction: Iron Deficiency (ID) is associated with increased mortality rates in patients with Heart Failure with reduced Ejection Fraction (HFrEF), as well as a general increase in morbidity compared with patients with normal iron levels.
Aim: To determine 5-year overall survival rates among HFrEF patients with ID anaemia and reduction in renal function treated with intravenous (IV) iron in a pilot study.
Materials and Methods: In this randomized controlled pilot study with a 5 years follow up, 40 patients from the general population that spontaneously consulted the outpatient’s office of the cardiology section at the Hospital Alemán Buenos Aires with HFrEF, renal impairment, anaemia, and ID were enrolled into two groups (n= 20/group). For 5 weeks, one group received isotonic saline solution and the other received IV iron sucrose, 200mg weekly. Over a 5-year follow-up period, overall survival and the number of hospitalizations were recorded, as well as variables associated with iron status, anaemia, HFrEF severity and cardiac function, renal function and level of inflammation.
Results: Among patients treated with IV iron sucrose, survival was 80% after 5 years, which was significantly greater than survival in the control group (45%, p<0.05 versus treated group). Throughout the study, there were fewer hospitalizations among patients treated with IV iron sucrose compared with those in the control group. After 5 years, 85% of patients in the control group had been hospitalized, more than four times than among iron-treated patients (p<0.01). Iron treatment also improved iron status, New York Heart Association class and renal function.
Conclusion: IV iron treatment increased survival in patients with HFrEF, renal impairment and ID anaemia, as well as reducing the number of patients requiring hospitalization over 5 years.