LONG-TERM RESULTS OF TREATMENT WITH IRON PREPARATIONS IN PATIENTS WITH HEART FAILURE AND IRON DEFICIENCY

Abstract

Heart failure is one of the leading causes of hospitalization worldwide. Multifactorial iron deficiency and anemia are common in patients with heart failure, contributing to the development of heart muscle dysfunction, associated with poor clinical outcome of heart failure and increased risk of death. The aim of our study was to investigate the effect of treatment with intravenous and oral iron on the clinical characteristics of patients with heart failure.

The study was carried out based on the approval of the Ethics Commission of Tbilisi State Medical University. Informed consent was obtained from the individual involved in the study. We studied 78 adult hospitalized patients who underwent a standard clinical evaluation. The blood samples of the persons involved in the study were analyzed for further parameters: complete blood count, serum iron concentration, ferritin, creatinine, estimated glomerular filtration rate. In addition, exercise tolerance was assessed using the 6-minute walk test, and quality of life was assessed using the Minnesota Questionnaire.

We divided the persons involved in the study into two groups: 50 of them (group I) received i/v iron (III) hydrochloride sucrose complex (Venofer) 5ml/100mg; 28 persons (II group) - were allocated as a control group. Duration of treatment in the group was 7.8±0.4 days. After discharge from the clinic, patients continued treatment with oral iron for 3 months. After 3 and 6 months, we repeatedly evaluated the clinical parameters in the subjects.

In our study, iron treatment at 3 months showed improvement in hematological parameters, heart failure functional class, NT-pro BNP level and renal function, but the difference between groups was not clinically significant. The 6-minute walk test and quality of life were significantly improved in the iron-treated group compared to the control group. The positive dynamics of the change of the mentioned parameters in the background of iron treatment was maintained 6 months after the start of the treatment.

Iron deficiency is common in patients with heart failure, its correction should be included in the treatment of heart failure. In patients with heart failure, it is important to check serum iron and ferritin together with the general blood test. Intravenous treatment with iron preparations is safe, well tolerated and improves patients' functional indicators and quality of life. Oral iron therapy can be used for long-term outpatient treatment. The positive dynamics of the results are maintained even after stopping the treatment.