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Intravenous Iron in Heart Failure: Beyond Targeting Anemia

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Abstract

Iron deficiency is commonly seen in congestive heart failure (CHF) in both anemic and nonanemic patients. In six studies in which these iron-deficient patients with CHF were treated with intravenous (IV) iron, five found an improvement in the hemoglobin. In uncontrolled and controlled studies, the New York Heart Association (NYHA) class, quality of life, and exercise capacity were improved consistently with IV iron. In some studies, cardiac function also was improved. In one large, double-blind, placebo-controlled study of IV iron, the patient global assessment, quality of life, and NYHA class improved rapidly in both those who were anemic or not anemic. In contrast to these studies, another controlled study of anemia in CHF showed no effect of oral iron on hemoglobin or on any cardiac parameters over 1 year. These studies suggest that CHF in both anemic and nonanemic iron-deficient patients may benefit from a course of IV iron, but not oral iron.

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Disclosures

Dr. Donald S. Silverberg has served as a consultant for Amgen and Vifor Pharmaceuticals (International); A. Iaina: none; D. Schwartz: none; D. Wexler: none.

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Authors and Affiliations

  1. Department of Nephrology, Tel Aviv Sourasky Medical Center, Weizman 6, Tel Aviv, 64239, Israel

    Donald S. Silverberg, Adrian Iaina & Doron Schwartz

  2. Department of Cardiology, Tel Aviv Sourasky Medical Center, Weizman 6, Tel Aviv, 64239, Israel

    Dov Wexler

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  1. Donald S. Silverberg
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  2. Adrian Iaina
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Correspondence to Donald S. Silverberg.

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Silverberg, D.S., Iaina, A., Schwartz, D. et al. Intravenous Iron in Heart Failure: Beyond Targeting Anemia. Curr Heart Fail Rep 8, 14–21 (2011). https://doi.org/10.1007/s11897-010-0034-4

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