Iron deficiency and supplementation in patients with heart failure: Results from the IRONHF international survey

Author:

Camilli Massimiliano12,Ballacci Federico1,Rossi Valentina Alice3,Cannatà Antonio45,Monzo Luca6,Mewton Nathan7,Girerd Nicolas6,Gentile Piero8,Marini Marco9,Mapelli Massimo10,Flammer Andreas J.311,Aspromonte Nadia12,Montone Rocco Antonio12,Lombardo Antonella12,Lanza Gaetano Antonio12,Savarese Gianluigi12,Ruschitzka Frank311,Crea Filippo113

Affiliation:

1. Department of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome Italy

2. Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy

3. Cardiology, University Heart Center, University Hospital Zurich Zurich Switzerland

4. King's College Hospital NHS Foundation trust London UK

5. School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Excellence, King's College London London UK

6. Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433 and Inserm U1116, CHRU Nancy, FCRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists) Nancy France

7. Heart Failure Department Clinical Investigation Center, INSERM 1060 & 1407, Hospices Civils de Lyon, University Claude Bernard Lyon 1 Lyon France

8. De Gasperis Cardio Center and Transplant Center, Niguarda Hospital Milan Italy

9. Cardiovascular Sciences Cardiology Department Ospedali Riuniti Ancona Italy

10. Centro Cardiologico Monzino IRCCS Milan Italy

11. Center for Translational and Experimental Cardiology Schlieren Switzerland

12. Division of Cardiology, Department of Medicine Karolinska Institute; and Heart and Vascular and Neuro Theme, Karolinska University Hospital Stockholm Sweden

13. Center of Excellence of Cardiovascular Sciences Ospedale Isola Tiberina ‐ Gemelli Isola Rome Italy

Abstract

AimsIron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, regardless of anaemia status. Iron supplementation has been demonstrated to improve exercise capacity and quality of life in patients with HF with an ejection fraction <50% and ID. This survey aimed to provide data on real‐world practices related to ID screening and management.Methods and resultsWe designed and distributed an online survey (23 questions) regarding ID screening and management in the HF setting. Overall, 256 cardiologists completed the survey (59.8% male, mostly between 30 and 50 years). The majority of physicians defined ID according to the most recent HF recommendations (98.4%) and reported screening for ID in more than half of their patients (68.4%). However, only 54.3% of the respondents performed periodic screening (every 6 months to 1 year). A total of 93.0% of participants prescribed and/or administered iron supplementation, using intravenous iron as the preferred method of administration (86.3%). After iron supplementation, 96.1% of the respondents reassessed ID, most frequently at 3–6 months (67.6%). Most physicians (93.8%) perceived ID as an underestimated comorbidity in HF. Cardiologists' age, training status, subspecialty and work setting (academic vs. non‐academic hospitals) were associated with heterogeneity in the answers.ConclusionsThe results of this survey highlight the need for more consistent strategies of ID screening and treatment for patients with HF.

Publisher

Wiley

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