Expert recommendations for the management of iron deficiency in patients with heart failure in Asia
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David Kheng Leng Sim1, Sanjay Mittal2, Jian Zhang3
1Department of Cardiology, National Heart Centre Singapore, Singapore.
Insights
Iron deficiency is common in heart failure (HF) and impacts quality of life. Asian expert recommendations guide screening, intravenous iron treatment, and monitoring for HF patients to improve care.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Iron deficiency is a frequent comorbidity in heart failure (HF), negatively impacting quality of life and exercise capacity.
- It increases hospitalization risk in HF patients, irrespective of anemia.
- Established international guidelines for iron deficiency management in HF exist, but are less developed in Asia.
Purpose of the Study:
- To provide expert guidance for managing iron deficiency in heart failure patients within the Asian community.
- To address the limited established guidelines and practical application of management strategies in the region.
Main Methods:
- A panel of cardiologists from various Asian countries convened to discuss and formulate recommendations.
- Expert opinions were gathered on screening, diagnosis, treatment, and monitoring of iron deficiency in HF.
Main Results:
- Recommendations include screening all heart failure with reduced ejection fraction patients for iron deficiency.
- Intravenous iron treatment is advised for iron-deficient HF patients, with annual or biannual monitoring.
- Identified barriers include low physician awareness, lack of reimbursement, and inadequate facilities for IV iron administration.
Conclusions:
- These expert recommendations offer a structured framework for managing iron deficiency in Asian heart failure patients.
- Implementation of these guidelines can help overcome regional barriers and improve patient outcomes.
Background:
Iron deficiency is a common comorbidity in heart failure (HF) and is independently associated with a worse quality-of-life and exercise capacity, as well as increased risk of hospitalization, regardless of anemia status. Although international guidelines have provided recommendations for the management of iron deficiency in patients with HF, guidelines in Asia are less established, and practical use of guidelines for management of iron deficiency is limited in the region.
Methods:
A panel comprising cardiologists from China, Hong Kong, India, Japan, Malaysia, Pakistan, Philippines, Singapore, South Korea, Taiwan, and Thailand convened to share insights and provide guidance for the optimal management of iron deficiency in patients with HF, tailored for the Asian community.
Results:
Expert opinions were provided for the screening, diagnosis, treatment and monitoring of iron deficiency in patients with HF. It was recommended that all patients with HF with reduced ejection fraction should be screened for iron deficiency, and iron-deficient patients should be treated with intravenous iron. Monitoring of iron levels in patients with HF should be carried out once or twice yearly. Barriers to the management of iron deficiency in patients with HF in the region include low awareness of iron deficiency amongst general physicians, lack of reimbursement for screening and treatment, and lack of proper facilities for administration of intravenous iron.
Conclusions:
These recommendations provide a structured approach to the management of iron deficiency in patients with HF in Asia.
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