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Iron Deficiency Screening in Patients Admitted with Acute Heart Failure Decompensation
Alex M Sindledecker1, Yassar Nabeel2,3,4, Olivia Palladino1
1Pharmacy - Cleveland Clinic Akron General, 1 Akron Gen Ave, Akron, OH, 44307, USA.
Journal of Cardiovascular Translational Research
|May 19, 2026
Summary
Iron deficiency is common in heart failure (HF) patients admitted to the hospital. However, iron status is infrequently assessed, missing opportunities for vital treatment in these heart failure patients.
Area of Science:
- Cardiology
- Nephrology
- Hematology
Background:
- Iron deficiency (ID) is prevalent in heart failure (HF) patients.
- Intravenous iron may improve outcomes in HF, but real-world data on its assessment and treatment are limited.
- Hospital admissions for decompensated HF offer a critical window for identifying and treating ID.
Purpose of the Study:
- To evaluate the frequency of iron deficiency assessment and treatment in hospitalized patients with decompensated heart failure.
- To identify factors associated with the assessment of iron status in this patient population.
Main Methods:
- Retrospective analysis of 2,275 hospital admissions for decompensated HF.
- Review of available iron studies (serum iron, ferritin, transferrin saturation).
- Analysis of patient demographics and comorbidities (anemia, chronic kidney disease, MCV) to predict iron study availability.
Main Results:
- Iron studies were available for only 23.1% of admissions.
- Iron deficiency was identified in 63.1% of patients with available studies.
- Anemia, CKD stage 3, and low MCV were associated with higher odds of iron study assessment; age was associated with lower odds.
- Only 12.5% of all admissions received intravenous iron during hospitalization.
Conclusions:
- Assessment and treatment of iron deficiency in hospitalized heart failure patients remain suboptimal.
- Factors related to anemia, rather than heart failure itself, appear to drive the assessment of iron status.
- There is a significant unmet need for systematic screening and management of iron deficiency in heart failure.
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