Anemia in heart failure is associated with increased morbidity and mortality; intravenous iron improves functional capacity, while erythropoiesis-stimulating agents show no mortality benefit.
Do iron supplements and erythropoiesis-stimulating agents improve clinical outcomes in patients with heart failure and anemia?
This review reinforces that intravenous iron improves symptoms in anemic heart failure patients, whereas erythropoiesis-stimulating agents do not improve clinical outcomes and are not recommended.
Anemia in heart failure patients is a relatively common finding and has been linked with an increased risk of hospital admissions, morbidities, and significant mortality making its correction a significant factor in improving the quality of life and clinical outcomes in those suffering from it. This review article has discussed the multifactorial pathophysiology, including iron deficiency, longstanding inflammation, abnormal levels of human erythropoietin (Epo), and the abnormal activation of the renin-angiotensin-aldosterone system (RAAS) being the most significant. The diagnostic guidelines as well as research-based management modalities specifically with iron supplements and erythropoietin stimulating agents have also been discussed, although research done in this area has been limited and shown conflicting results.
Siddiqui et al. (Sat,) conducted a review in Heart failure with anemia. Iron supplementation and erythropoiesis-stimulating agents was evaluated. Anemia in heart failure is associated with increased morbidity and mortality; intravenous iron improves functional capacity, while erythropoiesis-stimulating agents show no mortality benefit.