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Iron Replacement in Heart Failure

Improvement of functional capacity and quality of life with intravenous iron in iron deficiency.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Iron Replacement in Heart Failure?

Iron deficiency is a common comorbidity that worsens symptoms and exercise capacity in 50% of patients with heart failure (HF). Identification is independent of anaemia.

Diagnostic criteria are ferritin <100 ng/mL OR ferritin 100-300 + TSAT <20%. Improvement in NYHA class and quality of life with intravenous ferric carboxymaltose has been shown in HFrEF.

Symptoms

Heart failure symptoms (dyspnoea, fatigue)
Exercise intolerance
Pallor, weakness
Suboptimal HF response (despite optimal medical therapy)
Decrease in 6-minute walk test

Risk Factors

HFrEF (EF <40%)
NYHA II-IV symptoms
Chronic kidney failure
Female gender
Advanced age (>70)
Loop diuretic use (urinary iron loss)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent symptoms in HF + functional decline
  • Routine HF evaluation (ferritin, TSAT) in clinic visit
  • Tachycardia, hypoxaemia post-IV iron infusion (rare hypersensitivity)
  • Need for iron repletion before HF hospitalisation

Treatment Methods

01
IV ferric carboxymaltose (FCM 500-1000 mg single/divided dose)
02
IV ferric derisomaltose (alternative; rapid total dose)
03
Avoidance of oral iron (IV preferred owing to absorption problems)
04
Repletion check at 6-12 weeks (ferritin, TSAT)
05
Annual reassessment (recurrent deficiency in 30%)
06
Hypersensitivity precaution (slow infusion, observation)
07
Phosphate monitoring (hypophosphataemia after FCM)
08
Treatment-naïve HF screening (during diagnosis)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.