Key result
Iron deficiency affects 73% of clinic HFrEF patients, with lower HF hospitalizations than AFFIRM-AHF.
Why the study?
In the AFFIRM-AHF trial, IV iron reduced total heart failure hospitalizations in patients with acute heart failure and iron deficiency. The proportion of HFrEF patients at a specialized clinic with iron deficiency and how their heart failure hospitalization rate compares with the AFFIRM-AHF trial needed to be identified.
Cohort (n=100)
No
Answers are grounded in this paper and cite their sources.
Although 73% of HFrEF patients at a specialized clinic had iron deficiency, their heart failure hospitalization rate (21.6 per 100 patient-years) was markedly lower than in the AFFIRM-AHF trial (43.2 per 100 patient-years), questioning the need for routine IV iron repletion in this population.
Background: In the AFFIRM-AHF trial, IV administration of iron reduced total hospitalizations due to heart failure in patients with acute heart failure and iron deficiency. Objectives: To identify what proportion of patients with heart failure with reduced ejection fraction (HFrEF) had iron deficiency and to compare their rate of hospitalization due to heart failure with that of patients in the AFFIRM-AHF trial. Methods: This retrospective cohort study involved patients with HFrEF seen at a specialized heart failure clinic. Data were collected between February 2021 and August 2022. The primary outcome was the proportion of patients with iron deficiency, with comparison of the rate of hospitalization due to heart failure in this study relative to the AFFIRM-AHF trial. Results: A total of 284 patients were screened to generate the pre-specified sample of 100. Of these, 73% had iron deficiency. After clinic attachment, the rate of hospitalization due to heart failure among patients with iron deficiency was 21.6 per 100 patient-years, compared with 43.2 in the AFFIRM-AHF trial. Conclusions: Although more than two-thirds of patients with HFrEF in the study clinic had iron deficiency, their rate of hospitalization due to heart failure was markedly lower than that reported in the AFFIRM-AHF trial. Therefore, the need for routine IV iron repletion in these patients is questionable.
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Pryjma et al. (2026) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=100). Iron deficiency in HFrEF clinic cohort vs. AFFIRM-AHF trial cohort was evaluated on Proportion of patients with iron deficiency and rate of hospitalization due to heart failure (per 100 patient-years). Iron deficiency was present in 73% of HFrEF clinic patients, who had a lower HF hospitalization rate than the AFFIRM-AHF cohort.
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