Background Iron deficiency (ID) is an important comorbidity associated with chronic heart failure. This often leads to worsening functional class, quality of life and poor prognosis. Diagnosis and prompt treatment of ID are essential.
Purpose The aim of this study was to analyse compliance with a new protocol for intravenous ferric carboxymaltose (FCM) in the heart failure unit and the short term safety and analytical profile of intravenous FCM.
Material and methods A review was conducted by a multidisciplinary team (MT). After review, the MT decided to implement a new protocol using FCM in a definite group of patients. Absolute ID was defined as ferritin <100 μg/L, functional ID was defined as ferritin 100–299 μg/L and transferrin saturation (TSAT) <20%. All patients were administered intravenous FCM in one or two doses (maximum iron dose per infusion 1000 mg) in an outpatient setting. ID was calculated using the simplfied Ganzoni formula. Patient identification was performed using the electronic prescription programme; pharmaceutical validation mainly allowed us to identify prescription, dose, dilutions and the analytical parameters. The Student’s t-test for related samples was used to compare continuous variables before and after iron infusion. Statistical significance was defined as a two tailed p value <0.05.
Results 62 patients were analysed in this retrospective observational study. Mean age was 65.2±12.9 years, and patients were predominantly men (70%). Relevant laboratory parameters before and after treatment with intravenous FCM were requested and analysed according to the protocol. Haematological and iron status parameters: haemoglobin (13.04 vs 13.78 mg/dL), haematocrit (38.5 vs 41.6), blood iron level (67.85 vs 109.11 mg/dL), ferritin (79.65 vs 424.62 mg/dL) and TSAT (17.23% vs 33.64%) improved significantly (p<0.001) in the first 3 months after FCM infusion. No adverse reactions were observed during the study.
Conclusion In our study, this therapy safely and effectively corrected deficient iron stores in the short term. Studies that analysed the effects of intravenous iron treatment in patients with heart failure have demonstrated improved quality of life and functional capacity. The intravenous FCM protocol had an acceptable degree of compliance but the importance of diagnosis and monitoring patients must be stressed as the long term effects of intravenous iron therapy are not yet well defined.
No conflict of interest
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