Iron deficiency and cardiovascular disease

Area of Science:

• Cardiology
• Hematology
• Internal Medicine

Background:

• Iron deficiency (ID) is highly prevalent in cardiovascular disease (CVD), affecting up to 60% of coronary artery disease patients and a higher proportion of heart failure (HF) patients.
• ID prevalence escalates with cardiac and renal dysfunction severity and is more common in women.
• Causes of ID include inadequate intake, reduced absorption (hepcidin increase), and blood loss (e.g., from anti-thrombotic therapy).

Purpose of the Study:

• To investigate the role and therapeutic implications of iron deficiency in cardiovascular disease.
• To evaluate the efficacy of iron supplementation in heart failure with reduced ejection fraction (HFrEF).

Main Methods:

• Review of existing literature and evidence regarding iron deficiency in various cardiovascular conditions.
• Analysis of randomized trials investigating intravenous iron therapy in HFrEF patients.

Main Results:

• Iron deficiency is linked to poor prognosis in older adults and HFrEF patients, potentially conferring independent risk.
• Intravenous ferric carboxymaltose improved symptoms, quality of life, exercise capacity, and reduced HF hospitalizations in HFrEF patients (<50% ejection fraction).

Conclusions:

• Iron deficiency is a significant and treatable factor in HFrEF, warranting investigation even in non-anemic patients.
• Intravenous iron therapy is effective for HFrEF patients, suggesting broader applicability in CVD populations pending further research.