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Is Iron Therapy Indicated for Heart Failure with Reduced Ejection Fraction Patients?
1UCSF, medicine, San Francisco, California, United States; yamna.jadoon@ucsf.edu.
Canadian Journal of Physiology and Pharmacology
|August 5, 2026
Summary
Iron deficiency is common in heart failure with reduced ejection fraction, often leading to anemia. This review examines iron supplementation
Area of Science:
- Cardiology
- Hematology
- Nutritional Science
Background:
- Heart failure with reduced ejection fraction (HFrEF) is frequently associated with iron deficiency.
- Inflammation in HFrEF impairs iron absorption, contributing to anemia.
- Parenteral iron formulations offer safer administration routes for iron replacement therapy.
Purpose of the Study:
- To review the evidence for iron supplementation in patients with HFrEF.
- To provide recommendations for iron replacement based on current data.
- To assess the role of newer iron preparations in HFrEF management.
Main Methods:
- Systematic review of clinical trials and observational studies.
- Analysis of data from trials using oral iron salts.
- Inclusion of evidence from studies utilizing ferric carboxymaltose and ferric derisomaltose.
- Consideration of consensus statements and expert opinions.
Main Results:
- Iron deficiency is prevalent in HFrEF patients, impacting outcomes.
- Parenteral iron therapy has shown benefits in improving symptoms and exercise capacity in HFrEF.
- Oral iron may have a limited role due to absorption issues in this population.
Conclusions:
- Iron supplementation is a viable strategy for managing iron deficiency in HFrEF.
- Parenteral iron, particularly ferric carboxymaltose, is recommended for HFrEF patients with iron deficiency.
- Further research is needed to optimize iron therapy protocols in HFrEF.
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