Iron Deficiency, Anemia, and Iron Supplementation in Patients With Heart Failure: A Population-Level Study

Area of Science:

• Cardiology
• Hematology
• Public Health

Background:

• Iron deficiency (ID) is linked to adverse outcomes in heart failure (HF), regardless of anemia.
• Current treatment practices for ID in HF patients may not align with established guidelines.

Purpose of the Study:

• To investigate the prevalence of ID and iron deficiency anemia (IDA) in acute and chronic HF patients.
• To examine iron supplementation practices in these patient populations.
• To assess patient eligibility for ongoing clinical trials related to iron therapy in HF.

Main Methods:

• Utilized population-level data from Alberta, Canada (2012-2019) for adult HF patients.
• Categorized patients into acute or chronic HF, defining ID and IDA using laboratory criteria.
• Determined eligibility for AFFIRM-AHF, IRONMAN, and HEART-FID trials.

Main Results:

• High prevalence of ID (72.6% acute, 73.9% chronic) and IDA (51.4% acute, 49.0% chronic) among tested HF patients.
• Iron therapy was administered to 41.8% of acute and 40.5% of chronic HF patients with IDA, and 19.9%-21.7% of ID patients without anemia.
• Oral iron was the most common therapy (28.1%); approximately half the cohort qualified for major iron therapy trials.

Conclusions:

• Investigational and therapeutic approaches for ID in HF patients deviate from current guidelines.
• There is a significant gap in care regarding optimal iron management for HF patients.
• Innovative strategies are necessary to improve iron therapy utilization and patient outcomes in HF.