Date Published: 
Friday, 31 October, 2014

Long-term iron therapy may increase quality of life and reduce risk of hospitalisation in patients with symptomatic heart failure and iron deficiency, study reveals

Administering iron therapy to symptomatic, iron deficient patients with heart failure, over a one-year period, may result in sustainable improvement in functional capacity and symptoms, and may be associated with reduced hospitalisation. Authors of a new study state that, by targeting the iron deficiency in these patients overall quality of life (QoL) can be improved.

The study, Ferric CarboxymaltOse evaluatioN on perFormance in patients with IRon deficiency in coMbination with chronic Heart Failure (CONFIRM-HF), enrolled 304 symptomatic patients with heart failure (left ventricular ejection fraction ≤45%) and iron deficiency (ferritin <100 ng/mL or 100–300 ng/mL if transferrin saturation is <20%). Patients were randomised 1:1 to either ferric carboxymaltose (n=152) or placebo (saline, n=152) for 52 weeks.

Patients treated with ferric carboxymaltose demonstrated significantly prolonged 6 min-walk-test  distance at Week 24 (difference between ferric carboxymaltose vs placebo: 33 ± 11 minutes, p=0.002). Those treated with ferric carboxymaltose also showed a significant improvement in Patient Global Assessment from Week 12 onwards (p=0.035), in New York Heart Association class from Week 24 onwards (p=0.004) and a significant reduction in Fatigue Score from Week 12 onwards (p=0.009). Patients treated with ferric carboxymaltose also demonstrated an improvement in QoL. Treatment with ferric carboxymaltose was associated with a significant reduction in the risk of hospitalisations for worsening heart failure (hazard ratio [95% confidence interval]: 0.39 [0.19–0.82], p=0.009). Safety profiles were comparable between the two groups.

Symptomatic, iron deficient patients with heart failure may benefit from long-term treatment with ferric carboxymaltose through a sustainable improvement in functional capacity, symptoms, QoL and reduction in hospitalisation for worsening disease. The authors stated that there remains a need to evaluate the comparable efficacy of oral iron therapy in iron deficient patients with heart failure in large, randomised trials.

The full article is available in the August issue of the European Heart Journal. For information on iron deficiency in cardiology, please click here.