Read on Twitter
Let's talk about iron deficiency (ID) in patients with heart failure (HF)
Prevalence est. ~ 50% HF patients
HF is a chronic inflammatory state, so traditional ID markers are modified for dx
HF patients can have ID w/o anemia, screen everybody
1/5
Prevalence est. ~ 50% HF patientsHF is a chronic inflammatory state, so traditional ID markers are modified for dxHF patients can have ID w/o anemia, screen everybody1/5
FAIR-HF used the following definition of ID in HF:
ferritin<100 (absolute ID)
ferritin 100-299 IF trans sat < 20% (functional ID)
https://bit.ly/2WLTCRm
2/5
ferritin<100 (absolute ID)ferritin 100-299 IF trans sat < 20% (functional ID)https://bit.ly/2WLTCRm
2/5
Significance:
appropriate IV iron repletion has shown improvement in exercise capacity in symptomatic, ambulatory HF patients https://bit.ly/32Lbe3l
AND
reduced HF-related hospitalizations in a meta-analysis https://bit.ly/3g6QCGV
3/5
appropriate IV iron repletion has shown improvement in exercise capacity in symptomatic, ambulatory HF patients https://bit.ly/32Lbe3l
AND
reduced HF-related hospitalizations in a meta-analysis https://bit.ly/3g6QCGV
3/5
How do you replace iron?
https://bit.ly/2ZPU8zA
In hospitalized patient with large ID, consider IV (IIb)
Outpatient, consider TID oral ferrous sulfate (but poorly absorbed d/t gut edema, sig longer to replenish iron stores)
4/5
https://bit.ly/2ZPU8zA
In hospitalized patient with large ID, consider IV (IIb)
Outpatient, consider TID oral ferrous sulfate (but poorly absorbed d/t gut edema, sig longer to replenish iron stores)
4/5
PITFALLS & PEARLS
Total body iron has a narrow therapeutic window- iron overload can be deleterious, causing cardiac and liver toxicity
Each unit of PRBC contains approximately 300mg of iron
5/5
Total body iron has a narrow therapeutic window- iron overload can be deleterious, causing cardiac and liver toxicityEach unit of PRBC contains approximately 300mg of iron5/5
