Iron deficiency in heart failure: iatrogenic implications

Introduction: The etiology of anemia in heart failure is not fully understood, but multiple mechanisms in-volvement are suggested, among which a few classes of drugs: beta blockers, angiotensin-converting-enzyme inhibitor and digoxin.
Objective: We conducted a prospective observational study to evaluate the role of different classes of drugs concerning iron metabolism.
Methods: We included 128 patients consecutively admitted to our clinic with following characteristics: heart failure (with reduced or preserved ejection fraction) and absolute iron deficiency (iron <66μg/dl; ferritin <100μg/l) or functional iron deficiency (iron <66μg/dl; ferritin 100-300 μg/l with transfferin saturation <20%). The patients with other etiologies for iron deficiency were excluded from analysis.
Results: Out of 128 patients included, 28.12% were treated with calcium channel blockers. 97.22% of this patients were included in dihydropyridine class. He-moglobin (p=0.018), hematocrit (p=0.003) and iron (p=0.038) were significantly smaller in patients re-ceiving calcium channel blockers. Quality of life esti-mated by Kansas City Cardiomyopathy Questionair-re (p=0.01) and 6 minute walking test (p=0.02), were significantly higher in patients taking this treatment. The proportion of patients treated with beta blockers were 67.96%. The ferritin levels were significantly hi-gher (p=0.02) in this category of patients. An indirect statistic significantly correlation was found (p=0.04) between angiotensin-converting-enzyme inhibitors and hematocrit levels.
Conclusions: Calcium channel blockers and angioten-sin-converting-enzyme inhibitor give us statistic sig-nificantly data on this small study suggesting a multi-modal influence of the etiology of iron deficiency in patients with heart failure.

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)