AHA 2010: Iron Boosts Quality of Life in Chronic Heart Failure Patients

Chronic heart failure (CHF) patients who are iron-deficient may see rapid improvement in quality of life from intravenous treatment with the iron compound ferric carboxymaltose, researchers say. Because chronic heart failure patients show impaired health-related quality of life, this is an important target for therapeutic intervention.

Lead author Josep Comin Colet, MD, Hospital del Mar Heart Failure Program in Barcelona, presented the findings Tuesday at the American Heart Association Scientific Sessions 2010 in Chicago. Researchers analyzed 449 iron-deficient chronic heart failure patients randomly assigned in the double-blind study to receive the iron treatment or placebo for 24 weeks. Half were anemic and 75% of the patients reported moderate to severe pain.

Researchers measured chronic heart failure symptoms, quality of life, and exercise capacity at baseline and after four, 12, and 24 weeks. Analysis of data revealed:

• Chronic heart failure symptoms, quality of life, and exercise capacity improved with the intravenous ferric carboxymaltose.
• Patients saw results quickly. After just four weeks, patients receiving the iron treatment had a significantly improved quality of life compared to those who received the placebo.
• The beneficial effects of intravenous ferric carboxymaltose on quality of life were also seen at the later check-ins (12 and 24 weeks).
• Significant improvements were seen with ferric carboxymaltose in the distance on the 6-minute walk test. The rates of death, adverse events and serious adverse events were similar in the two study groups.
• Improvements were not influenced by patients’ anemia status suggesting that iron status should be assessed in all CHF patients regardless of the presence of anemia.
• Side effects and adverse event rates were acceptable.

Recently, it has been recognized that patients with heart failure may develop iron deficiency because iron stores have been depleted or their iron absorption is defective. Colet said the intravenous method was used because the class of patients in the study had trouble with oral absorption of the iron compound.

Another study, led by Piotr Ponikowski, MD, PhD, Medical University, Wroclaw, Poland, showed that ferric carboxymaltose also improves kidney function in some chronic heart failure patients.

Renal dysfunction commonly complicates the natural course of chronic heart failure and predicts poor outcomes. Currently applied CHF therapies have either no effect on or even worsen renal function. Ponikowski’s study shows that treatment with intravenous ferric carboxymaltose improved symptoms and quality of life across the board for the CHF patients regardless of age, sex, CHF severity, underlying CHF etiology, or anemia status.