Parenteral Iron Therapy in Patients with Heart Failure in a Resource Constrained Setting In India - Our Experience

To assess the prevalence of Iron Deficiency and impact of Parenteral Iron therapy in patients with Symptomatic Heart failure, the role of exercise capacity and serial Echocardiography in assessing treatment response.

Study was performed in a Government Hospital for 24 months, December 2017 to December 2019.120 participants were recruited. Patients with symptomatic heart failure and Serum Ferritin <100 mg/dl were recruited and those with diagnosed Ischemic Cardiomyopathy or unwilling to give consent were excluded. They underwent a functional assessment and 2D Echo at baseline, after 30 and 90 days of IV Carboxymaltose. The data was analysed represented in appropriate figures. A P value <0.05 was considered significant.

Of 120 patients recruited, 28 were male and 92 were female. The mean age of presentation was 44 +/- 5.4 years. The Mean baseline Haemoglobin was 11.7 +/- 0.38 gm/dl.The baseline Ferritin levels were 16.69 +/-2.9 ug/L. HFpEF was predominant with 65% cases. The NYHA status and 6min HWT tests showed a statistically significant improvement and Echocardiography findings showed a statistically insignificant improvement after Parenteral Iron.

Iron Deficiency is a major risk factor in Heart Failure including HFpEF and prevails in the younger population.Parenteral Iron Carboxymaltose followed by oral iron supplementation is effective in Heart Failure patients, especially in HFpEF. Functional capacity and NYHA status appear to be the time tested markers for Iron repletion.