The role of oral iron treatment in patients with heart failure and iron deficiency

Introduction: According with the latest guideline, the treatment for iron deficiency in heart failure is intrave-nous iron. This treatment is expensive and poses some technical challenges especially in ambulatory treated patients. The role of oral iron in this category of pa-tients is not fully understood. In this context, we con-ducted a prospective observational study to evaluate the role of oral iron in patients with heart failure and iron deficiency.
Methods: We included 129 patients consecutively admitted to our clinic with following characteristics: heart failure (with reduced or preserved ejection frac-tion) and absolute iron deficiency (iron <66 μg/dl; fer-ritin <100 μg/l) or functional iron deficiency (iron <66 μg/dl; ferritin 100-300 μg/l with transfferin saturation <20%). The patients with other etiologies for iron de-ficincy were excluded from analysis. Two types of oral iron were used comparatively (iron sulfate and liposo-mal iron) and the patients were monitored for 24 weeks to evaluate the efficiency of this treatment on iron me-tabolism and quality of life estimated by Kansas City Cardiomyopathy Questionnaire.
Results: In oral treated patients (iron sulfate and li-posomal iron) we could not find a statistically signi-ficant increase of hemoglobin (p=0.722 respectively p=0.112), hematocrit (p=0.910 respectively p=0.199), iron (p=0.206 respectively p=0.815), ferritin (p=0.849 respectively p=0.849) after 6 months of treatment. The-re was no improvement on quality of life (p=0.718 re-spectively p=0.087) on this category of patients.
Conclusions: Other published studies show no bene-fits of oral iron in patients with iron deficiency and heart failure. Our results sustain these research and the probable explanations are represented by poor intes-tinal absorption of oral iron and reduced compliance secondary to multiple side effects of these drugs.

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)