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Giving intravenous iron to patients with symptomatic heart failure is safe and cost effective

James Redfern1, Rachel Goode1, Wing Yin Leung1

  • 1Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK.

British Journal of Hospital Medicine (London, England : 2005)
|June 2, 2021
PubMed

Insights

Intravenous iron therapy with ferric carboxymaltose is safe and cost-effective for iron-deficient heart failure patients. This treatment improved iron levels and generated income, suggesting its viability for clinical integration.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Heart failure impacts 1 million UK individuals, affecting quality of life, function, and cognition.
  • Iron deficiency affects approximately 50% of heart failure patients, worsening outcomes.
  • Intravenous ferric carboxymaltose has demonstrated improvements in quality of life for heart failure patients.

Purpose of the Study:

  • To evaluate the feasibility, safety, and cost-effectiveness of implementing an intravenous iron service.
  • To assess the impact of intravenous ferric carboxymaltose on iron status in heart failure patients.

Main Methods:

  • A quality improvement project was conducted.
  • 61 iron-deficient heart failure patients received intravenous ferric carboxymaltose between July and December 2019.
  • Feasibility, safety, and cost implications were assessed.

Main Results:

  • Significant improvements in ferritin (83.3 to 433 ug/L), transferrin saturation (18% to 30%), and hemoglobin (126 to 135 g/L) were observed (P<0.0001).
  • No significant changes in New York Heart Association class or quality of life scores were noted.
  • The service generated a net income of £240 per patient.

Conclusions:

  • Intravenous iron replacement with ferric carboxymaltose is safe and cost-effective for eligible iron-deficient heart failure patients.
  • Integration with existing day case services offers a logistically simple and economically viable delivery model.
  • This approach should be considered for managing iron deficiency in symptomatic heart failure.
Abstract

Keywords:
Heart FailureIntravenousIron

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