Use of intravenous iron in patients with iron deficiency and chronic heart failure : Real-world evidence
Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved..
INTRODUCTION AND OBJECTIVES: Treatment with intravenous iron in patients with heart failure (HF) and iron deficiency (ID) improves symptoms, however its impact on survival and safety is unknown. We aimed to evaluate the management of ID and anemia with intravenous iron in patients with HF and long-term safety of intravenous iron.
METHODS: We evaluated anemia and ID in patients with chronic HF at 3 university hospitals. Anemia was defined using the World Health Organization definition and ID was defined as ferritin <100 ug/L or a Transferrin Saturation <20% if ferritin between 100 and 299 ug/L. We assessed treatment with intravenous iron during follow-up and its association with mortality and HF hospitalizations using multivariate cox regression analysis.
RESULTS: We included 2,114 patients, median age 72 years and 57% had reduced left ventricular ejection fraction. ID was present in 55% and ID and anemia in 29%. Treatment with intravenous iron was used in 24% of patients with ID and 34% of patients with ID and anemia. In patients with ID, after multivariate adjustment, treatment with intravenous iron was associated with lower all-cause mortality: HR = 0.38 (0.28-0.56), lower cardiovascular mortality: HR = 0.34 (0.20-0.57) and no differences in HF hospitalizations: HR = 1.15 (0.88-1.50). Similar outcomes were found for patients with anemia and ID.
CONCLUSIONS: In a real-world cohort of patients with HF, treatment with intravenous iron was used in one third of patients with ID and anemia and appears safe in mid-term follow-up.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:80 |
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| Enthalten in: |
European journal of internal medicine - 80(2020) vom: 15. Okt., Seite 91-98 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gonzalez-Costello, José [VerfasserIn] |
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| Links: |
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| Themen: |
Anemia |
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| Anmerkungen: |
Date Completed 15.02.2021 Date Revised 15.02.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejim.2020.04.031 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM310215447 |
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| 100 | 1 | |a Gonzalez-Costello, José |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Use of intravenous iron in patients with iron deficiency and chronic heart failure |b Real-world evidence |
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| 500 | |a Date Revised 15.02.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a INTRODUCTION AND OBJECTIVES: Treatment with intravenous iron in patients with heart failure (HF) and iron deficiency (ID) improves symptoms, however its impact on survival and safety is unknown. We aimed to evaluate the management of ID and anemia with intravenous iron in patients with HF and long-term safety of intravenous iron | ||
| 520 | |a METHODS: We evaluated anemia and ID in patients with chronic HF at 3 university hospitals. Anemia was defined using the World Health Organization definition and ID was defined as ferritin <100 ug/L or a Transferrin Saturation <20% if ferritin between 100 and 299 ug/L. We assessed treatment with intravenous iron during follow-up and its association with mortality and HF hospitalizations using multivariate cox regression analysis | ||
| 520 | |a RESULTS: We included 2,114 patients, median age 72 years and 57% had reduced left ventricular ejection fraction. ID was present in 55% and ID and anemia in 29%. Treatment with intravenous iron was used in 24% of patients with ID and 34% of patients with ID and anemia. In patients with ID, after multivariate adjustment, treatment with intravenous iron was associated with lower all-cause mortality: HR = 0.38 (0.28-0.56), lower cardiovascular mortality: HR = 0.34 (0.20-0.57) and no differences in HF hospitalizations: HR = 1.15 (0.88-1.50). Similar outcomes were found for patients with anemia and ID | ||
| 520 | |a CONCLUSIONS: In a real-world cohort of patients with HF, treatment with intravenous iron was used in one third of patients with ID and anemia and appears safe in mid-term follow-up | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Anemia | |
| 650 | 4 | |a Chronic heart failure | |
| 650 | 4 | |a Intravenous iron | |
| 650 | 4 | |a Iron deficiency | |
| 650 | 4 | |a Safety outcomes | |
| 650 | 7 | |a Iron |2 NLM | |
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| 700 | 1 | |a Farré, Nuria |e verfasserin |4 aut | |
| 700 | 1 | |a Moliner-Borja, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Enjuanes, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a de Antonio, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Fuentes, Lara |e verfasserin |4 aut | |
| 700 | 1 | |a Díez-López, Carles |e verfasserin |4 aut | |
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| 700 | 1 | |a Manito, Nicolás |e verfasserin |4 aut | |
| 700 | 1 | |a Pujol, Ramón |e verfasserin |4 aut | |
| 700 | 1 | |a Comin-Colet, Josep |e verfasserin |4 aut | |
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