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Tag Archives: iron deficiency

March 2021 Br J Cardiol 2021;28:14–18 doi:10.5837/bjc.2021.010

Study of patients with iron deficiency and HF in Ireland: prevalence and treatment budget impact

Bethany Wong, Sandra Redmond, Ciara Blaine, Carol-Ann Nugent, Lavanya Saiva, John Buckley, Jim O’Neill

Abstract

Introduction Heart failure (HF) is a clinical syndrome characterised by breathlessness, leg swelling and fatigue, which is caused by a primary cardiac abnormality. HF can be categorised into HF with a reduced ejection fraction (HFrEF; ejection fraction <50%) or HF with a preserved ejection fraction (HFpEF; ejection fraction >50%).1 It was estimated in 2012, in Ireland, that 90,000 people had HF, with another 160,000 people at risk of developing the disease.2 There are also an estimated 10,000 new cases of HF every year.2 Both prevalence and incidence have likely increased since 2012 due to the ageing population and increases in comorbid

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Iron deficiency in heart failure: Introduction

February 2021

Iron deficiency in heart failure: Introduction

Iain Squire

Abstract

Contents Prevalence, causes, diagnosis and guidelines for treatment Mohamed Eltayeb, Vishnu Ashok, Iain Squire United Kingdom treatment of iron deficiency in heart failure: are we missing opportunities? Chun Shing Kwok, Sarah McDermott, Sadie Bennett, Simon Duckett Intravenous iron therapies and their differences Paul Foley Iron deficiency – the invisible comorbidity in HF: prioritising QoL as a target for treatment Jacquelyn Hooper, Nick Hartshorne-Evans, Colin Cunnington, Fozia Zahir Ahmed Conclusions Iain Squire

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Prevalence, causes, diagnosis and guidelines for treatment

February 2021 Br J Cardiol 2021;28(suppl 1):S3–S6 doi:10.5837/bjc.2021.s01

Prevalence, causes, diagnosis and guidelines for treatment

Mohamed Eltayeb, Vishnu Ashok, Iain Squire

Abstract

Pathophysiology Anaemia is a common comorbidity in heart failure (HF) and is strongly associated with disease severity, prognosis and mortality.1 The pathophysiology behind the high prevalence of anaemia in HF, and its association with adverse outcomes, is complex and multi-factorial.2 Some of the key factors involved include renal impairment, chronic inflammation, medications and haematinic deficiency, in particular iron deficiency (ID).3 ID is typically defined as a serum ferritin level <30 µg/L and transferrin saturation <20%.4 ID has better predictive value in identifying risk of long-term unfavourable outcomes in patients with chr

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February 2021 Br J Cardiol 2021;28(suppl 1):S7–S9 doi:10.5837/bjc.2021.s02

United Kingdom treatment of iron deficiency in heart failure: are we missing opportunities?

Chun Shing Kwok, Sarah McDermott, Sadie Bennett, Simon Duckett

Abstract

Introduction Iron deficiency in patients with heart failure with reduced ejection fraction (HFrEF) is common, affecting 60% of patients with hospitalisation for heart failure or worsening heart failure in the outpatient setting.1 Patients with heart failure are iron deficient for multiple reasons, including poor nutrition, malabsorption, reduced intracellular uptake of iron and blood loss.2 Two meta-analyses of randomised-controlled trials (RCTs) have shown the benefits of restoring iron levels in improving quality of life, exercise tolerance and reducing hospitalisation for heart failure, although, as of yet, no mortality benefit has been se

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Intravenous iron therapies and their differences

February 2021 Br J Cardiol 2021;28(suppl 1):S10–S14 doi:10.5937/bjc.2021.s03

Intravenous iron therapies and their differences

Paul Foley

Abstract

Introduction Iron deficiency has a major impact on cellular function, which is important in patients with heart failure with reduced ejection fraction because the prevalence is high. Interestingly, iron deficiency is not synonymous with anaemia – 50–73% of heart failure (HF) patients are iron deficient, yet 46% are not anaemic.1 The familiar response to treatment with iron, an increase in haemoglobin, does not always occur with iron treatment in patients with heart failure, yet replenishment does improve mitrochondrial function. It is notable that iron-containing proteins have a vital role in cellular energy metabolism. Remarkably, very

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February 2021 Br J Cardiol 2021;28(suppl 1):S15–S18 doi:10.5837/bjc.2021.s04

Iron deficiency – the invisible comorbidity in HF: prioritising QoL as a target for treatment

Jacquelyn Hooper, Nick Hartshorne-Evans, Colin Cunnington, Fozia Zahir Ahmed

Abstract

Introduction Despite significant advances in treatment, many patients with heart failure (HF) have poor outcomes, with one- and five-year mortality worse than most cancers.1 In view of this, improving quality of life (QoL) for patients with HF is considered a key target for treatment.2-4 Among patients with HF, iron deficiency (ID) is prevalent and affects up to 50% of patients.5 Like HF, ID is not only associated with increased morbidity and mortality, but it is also associated with reduced QoL.6,7 As the predominant symptoms of ID (fatigue, breathlessness and lethargy) particularly with anaemia, are often indistinguishable from those of HF,

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February 2021 Br J Cardiol 2021;28(suppl 1):S19 doi:10.5837/bjc.2021.s05

Conclusions

Iain Squire

Abstract

Professor Iain Squire However, identification of patients with iron deficiency is challenging and awareness of the importance of iron deficiency varies widely among clinicians caring for patients with heart failure; consequently, implementation of guideline-recommended IV iron supplementation is inconsistent, resulting in a large proportion of potentially eligible patients missing out on this therapy. Kwok and colleagues2 have described their early experience in integrating IV iron supplementation into their heart failure service, a model for others looking to follow-suit. As described in each of the articles, the data supporting IV iron supp

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News from the Cardiorenal Forum 12th Annual Scientific Meeting – Improving treatments in cardiorenal patients

March 2018

News from the Cardiorenal Forum 12th Annual Scientific Meeting – Improving treatments in cardiorenal patients

Fazlullah Wardak and Rosie Kalsi

Abstract

Do new diabetes drugs protect the heart and kidney? The day’s keynote session was given by Professor Johannes Mann (Friedrich Alexander University of Erlangen, Germany). Diabetes management has been transformed with the introduction of newer agents with the promise of cardiovascular and renal protection. The sodium glucose co-transporter-2 (SGLT-2) inhibitors are known to reduce the hyperfiltration, which occurs in early diabetic nephropathy. Glucagon-like peptide 1 (GLP-1) receptor agonists are incretin mimetics, which have several benefits for diabetes management. The mechanisms by which GLP-1 agonist therapy may reduce blood pressur

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October 2017

ESC 2017: Evidence supports treatment of iron deficiency in heart failure

BJC staff

Abstract

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

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March 2012 Br J Cardiol 2012;19:15

Correspondence: Anaemia in CHF

Mohammed Shamim Rahman, Matthew Pavitt, TP Chua

Abstract

Anaemia in chronic heart failure: what constitutes optimal investigation and treatment? Dear Sirs, We read with interest the recent supplement on anaemia in heart failure patients.1 Since the publication by Bolger et al.2 on the benefits of intravenous iron therapy in chronic heart failure (CHF), we have been screening for anaemia and iron deficiency in this cohort. We actively treat these patients based on the criteria of a haemoglobin level less than 12 g/dL, already on optimal conventional heart failure therapy, New York Heart Association (NYHA) class II symptoms or worse, and a ferritin of less than 100 μg/L. We were previously using an

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