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 AlemĂˇn, 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 outpatientâ€™s office of the cardiology section at the Hospital AlemĂˇn 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.