The document discusses the prevalence and management of iron deficiency in patients with heart failure (HF), highlighting its impact on health outcomes and quality of life. It notes various intravenous iron preparations and their effectiveness, while emphasizing the importance of recognizing and treating iron deficiency in HF to alleviate symptoms and reduce hospitalizations. Several clinical studies are referenced to support the findings on the management of iron deficiency in this patient population.

1. ACC/AHA/HFSA (2017)2
ESC (2016)3
AND
Ferritin <100 mcg/L
Ferritin 100-299 mcg/L
if transferrin saturation <20%
ORHFrEF
and
symptoms
COR IIa LOE A
NYHA
II-III
AND
Ferritin <100 ng/mL
Ferritin 100-300 ng/mL
if transferrin saturation <20%
OR
COR IIb LOE B-R
No iron deficiency / no anemia
No iron deficiency / anemia
Iron deficiency / no anemia
Iron deficiency / anemia
Frequency of Iron Deficiency
in Patients With HF, %
Prevalence1
NYHA I
n = 121
NYHA II
n = 577
NYHA III
n = 712
NYHA IV
n = 96
Pathophysiology4
Guidelines
Iron Deficiency
Inflammation
↓ Transferrin
HFrEF
Signs and Symptoms
IV iron may alleviate worsening HF
symptoms and reduce hospitalizations
Recognizing and Treating Iron Deficiency in Patients With Heart Failure:
Achieving Better Outcomes and Quality of Life
Full references, accreditation, and disclosure information available at PeerView.com/FCG930
Recognizing Iron Deficiency in Patients With Heart Failure: Prevalence, Pathophysiology, and Guidelines

2. IV Iron Preparations5,6
• Polypharmacy
• Poor adherence
• GI toxicity
• Ineffective
• Iron dextran (HMW)
• Iron dextran (LMW)
• IV ferric gluconate
• IV iron sucrose
• Ferumoxytol injection
• IV ferric carboxymaltose
IV Iron Sucrose and IV Ferric Carboxymaltose in HF:
Summary of Clinical Outcomes7
FAIR-HFpEF8
N = 200; FCM, PBO
PREFER-HF9
N = 72; FCM, FS, SI, PBO
HFpEF Jun 2020Jul 2019
FAIR-HF210
N = 1,200; FCM, PBO
IRONMAN11
N = 1,300; IIM ± SOC
HEART-FID12
N = 3,014; FCM, PBO
HFrEF Oct 2020 Feb 2021 Jun 2022
Affirm-AHF13
N = 1,100; FCM, PBO
Acute HF Aug 2020
• 6MWD
• QOL
• LVEF
• Peak VO2
• NYHA class
• Hospitalization
• NT-proBNP
IV Iron
Emerging Evidence
IV Iron
Current Knowledge
Oral Iron4
• Safe
• Simple administration
• Inexpensive
Recognizing and Treating Iron Deficiency in Patients With Heart Failure:
Achieving Better Outcomes and Quality of Life
Full references, accreditation, and disclosure information available at PeerView.com/FCG930
Managing Iron Deficiency in Patients With Heart Failure