Annals of Hematology

, Volume 98, Issue 10, pp 2293–2297 | Cite as

Iron deficiency in heart failure, an underdiagnosed and undertreated condition during hospitalization

  • Ronak MistryEmail author
  • Hitomi Hosoya
  • Andrew Kohut
  • Patricia Ford
Original Article


Heart failure (HF) is a chronic medical condition affecting an estimated 1–2% of the world’s population, and as many as 10% of patients age 65 and above. Among patients with HF, iron deficiency (ID) has an estimated prevalence of 30–83%, often without concomitant anemia. Thus, ID in HF is often underdiagnosed unless actively sought after. ID in HF has been shown to be an independent contributor of increased mortality, hospitalization, and early readmission compared with HF patients without ID or HF patients with anemia without ID. Previous trials suggest that intravenous iron supplementation for patients with chronic HF and ID with or without anemia has resulted in improved functional outcomes and quality of life; however, the role of iron supplementation in patients hospitalized with HF has not been well characterized. In this retrospective analysis conducted in a large urban health system, we show that of the greater than 10,000 patients admitted for HF in 1 year, only 158 patients underwent screening for ID. Of these, 109 met criteria for ID. Despite intravenous iron being the standard of care for treatment of ID in HF patients, only 23 patients received this therapy. These data suggest that iron deficiency, despite having major implications in HF, is not being adequately evaluated during hospitalizations for HF. Further, if ID is identified, it is not being appropriately addressed, as per current treatment guidelines.


Iron deficiency Heart failure Anemia Intravenous iron 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Pennsylvania (confirmation number: cgdeedbi) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal MedicinePennsylvania Hospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Penn Heart and Vascular Center Washington SquarePennsylvania Hospital of the University of PennsylvaniaPhiladelphiaUSA
  3. 3.Abramson Cancer CenterPennsylvania Hospital of the University of PennsylvaniaPhiladelphiaUSA

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