Tag Archives: FAIR HF

This topic was addressed by Dr Carolyn Lam (National Heart Centre, Singapore) during a Vifor satellite symposium. Iron deficiency is frequently defined as a serum ferritin <100 μg/L (or 100–299 ng/ml, if transferrin saturation [TSAT] <20%); the usual iron deficit in a 35–70 kg heart failure patient with a haemoglobin 10–14 g/dl is 1,000 mg. Iron deficiency is common irrespective of haemoglobin, sex, ethnicity, and even ejection fraction. In heart failure patients it adversely affects: functional status, including exercise capacity quality of life outcome Iron deficiency (but not anaemia) is associated with adverse prognosis. My

Systems of heart failure delivery Best practice tariff There is now a ‘best practice tariff’ (BPT) programme for heart failure (and for many other conditions). Professor Iain Squire (University of Leicester) reviewed the implications of this and discussed National Institute for Health and Care Excellence (NICE) quality standards for chronic heart failure (CHF). The first year of the BPT (April 2015–March 2016) was voluntary but it has been compulsory since the beginning of the 2016–2017 financial year. For the financial year 2016–2017, the tariff is worth a 5% uplift in the amount a trust is paid for each and every admission. It is

Acute heart failure The first of the clinical heart failure sessions, delivered by Professor Theresa McDonagh (King’s College Hospital, London), considered the definition of acute heart failure (AHF) and how this has been simplified over recent years from a minefield of overlapping statements set out in 2008. Acute hypertensive heart failure, acutely decompensated chronic heart failure, acute coronary syndrome (ACS) and heart failure, right heart failure – amongst other terminology – have now been categorised into: ‘puffers’ – pulmonary oedema, fluid distribution error and ‘bloaters’ – peripheral oedema with genuine fluid

The situation in the anaemia of CHF is less advanced, but in recent years there has been increasing interest in the use of both of these treatment strategies. A few small clinical trials have suggested some potential benefits of stimulating erythropoiesis with ESA therapy in heart failure anaemia, whilst the administration of IV iron has shown similar benefits even in the absence of ESA therapy. Indeed, the recently published FAIR-HF (Ferinject® Assessment in patients with Iron deficiency and chronic Heart Failure) trial1 has opened the eyes of cardiologists to the potential for this latter treatment strategy to improve the symptoms and sig

Epidemiology of anaemia in CKD The likelihood of anaemia occurring in CKD increases as renal function declines. All patients receiving haemodialysis therapy will require treatment for anaemia, and so too will almost all of those receiving peritoneal dialysis (the difference accounted for by haemodialysis exposing the patient to a greater inflammatory state, and also regular minor blood losses). Below a glomerular filtration rate (GFR) of 45 ml/min, erythropoietin secretion by the kidney declines and when patients enter stage 4 CKD (eGFR < 30 ml/min), around 30–40% will be anaemic. Aetiology of anaemia in CKD Figure 1. Factors contributi