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Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study

Federico Capone1, Alberto Cipriani2, Leonardo Molinari1

  • 1Department of Medicine (DIMED), University of Padua, Via Giustiniani, 2, 35128 Padova, Italy.

Journal of Personalized Medicine
|August 25, 2023
PubMed

Insights

Iron deficiency (ID) treatment with ferric carboxymaltose (FCM) in acute decompensated heart failure (ADHF) requires achieving target doses and outpatient follow-up for clinical benefits. Inadequate dosing and short-term treatment in this ADHF cohort did not correct ID or improve outcomes.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Iron deficiency (ID) is a common comorbidity in heart failure (HF) with reduced ejection fraction.
  • Ferric carboxymaltose (FCM) is a recommended treatment for ID in HF.
  • The clinical significance of ID screening and FCM treatment in acute decompensated heart failure (ADHF) requires real-world evaluation.

Purpose of the Study:

  • To evaluate the real-life clinical significance of iron deficiency screening and ferric carboxymaltose treatment in patients with acute decompensated heart failure (ADHF).

Main Methods:

  • A cohort of 104 ADHF patients were assessed for iron status.
  • Iron deficiency was detected in 81.1% of patients (n=73).
  • 55 patients received in-hospital ferric carboxymaltose (FCM), with only 13 reaching the target dose.

Main Results:

  • No significant differences in mortality or rehospitalization rates were observed between FCM-supplemented and unsupplemented patients.
  • Iron deficiency persisted in 75% of FCM-treated patients and 69.2% of untreated patients at follow-up.
  • Only 14.5% of FCM-supplemented patients received continued treatment after discharge.

Conclusions:

  • In this real-world ADHF cohort, ferric carboxymaltose (FCM) was often underdosed and did not effectively correct iron deficiency.
  • Achieving the target FCM dose and ensuring outpatient treatment are crucial for correcting iron deficiency and achieving long-term clinical benefits in ADHF patients.
  • Current real-life practices for FCM administration in ADHF may not yield the intended clinical improvements.

Keywords:
acute decompensated heart failureferric carboxymaltoseiron deficiencyreal-life experience

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