Key result
In a real-world French registry of 2,822 heart failure patients, only 38.1% underwent diagnostic testing for iron deficiency, and among HFrEF patients diagnosed with ID, only 39.3% received recommended intravenous iron supplementation.
Why the study?
This study aimed to assess the prevalence, clinical characteristics, and real-life clinical application of European Society of Cardiology guidelines for iron deficiency diagnostic testing and iron supplementation in heart failure.
Cross-Sectional (n=2,822)
Yes
Real-world clinical practice in France shows poor adherence to ESC guidelines for iron deficiency screening and intravenous iron supplementation in heart failure patients.
Suboptimal iron deficiency testing and IV iron use persist in heart failure; leaves open effective implementation strategies.
AIMS: Iron deficiency (ID) occurs in about 50% of patients with heart failure (HF). The European Society of Cardiology (ESC) recommends ID diagnostic testing in newly diagnosed patients with HF and during follow-up, with intravenous iron supplementation (IS) only recommended in patients with HF with reduced ejection fraction (HFrEF). This study aimed to assess prevalence, clinical characteristics, and application of ESC guidelines for ID and IS in patients with HF in the real-life clinical setting. METHODS AND RESULTS: The French transversal multicentre OFICSel registry (300 cardiologists) conducted in 2017 included patients hospitalized for HF at least once in the previous 5 years. Diverse adult patients were eligible including inpatients and outpatients and those with acute and chronic HF. Data were collected from cardiologists and patients using study-specific surveys. Data included demographic and clinical data, as well as HF and ID management data. Overall, 2822 patients, mainly male (69.3%) with a median age of 69 years (interquartile range 58-78), were included. A total of 1075 patients (38.1%) were tested for ID, with 364 (33.9%) diagnosed. Of these, 168 (46.2%) received IS: 128 (76.2%) intravenous IS and 40 (23.8%) oral. Among the 201 patients with HFrEF diagnosed with ID, 99 (49.3%) received IS: 79 (79.8%) intravenous IS and 20 (20.2%) oral. CONCLUSIONS: In clinical practice, only one-third of patients with HF had a diagnostic test for ID. In patients with ID with HFrEF, only 39.3% received intravenous IS as recommended. Thus, in general, cardiologists should be encouraged to follow the ESC guidelines to ensure optimal treatment for patients with HF.
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Pezel et al. (2021) conducted a cross-sectional in Heart failure (n=2,822). Guideline-directed iron deficiency diagnostic testing and supplementation was evaluated on Proportion of patients tested for iron deficiency. In a real-world French registry of 2,822 heart failure patients, only 38.1% underwent diagnostic testing for iron deficiency, and among HFrEF patients diagnosed with ID, only 39.3% received recommended intravenous iron supplementation.
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