Intravenous iron (III) carboxymaltose results in significantly fewer hospital readmissions in patients with heart failure and iron deficiency compared with placebo. This is the conclusion of a study published in Lancet and now presented. This is the first study to demonstrate the benefits of supplemental iron therapy in stabilized patients hospitalized for acute heart failure.
After hypertension, heart failure (HI) is the second most common cardiovascular reason for physician consultation. estimated prevalence in Switzerland is 175,000 patients, incidence is 12,000-15,000 new cases per year. However, only about 30% of HI patients with iron deficiency are treated at all, even though acute HI has a very high re-hospitalization rate and a poor prognosis. The 1-year lethality is 20-30%. However, the prevalence of iron deficiency in HI patients in Switzerland is 33% (absolute iron deficiency) and 21% (functional iron deficiency) according to evaluations. With this in mind, the AFFIRM-AHF study was launched. The multicenter, randomized, double-blind, placebo-controlled study enrolled 1108 patients and followed them up to 52 weeks. All had been stabilized in hospital due to acute heart failure. Evaluated the effect of intravenous ferric carboxymaltose (Ferinject®/FCM) on re-hospitalization of HI patients and cardiovascular mortality in patients with iron deficiency. The average total FCM dose was 1352 mg. 80% of patients in the verum group received one or two administrations during the study. It was shown that one in four HI patients with iron deficiency could be spared re-hospitalization by intravenous administration of ferric carboxymaltose without increasing mortality. The “number needed to treat” to avoid hospitalization or cardiovascular death was only seven. The study results support the need to screen patients with acute heart failure more frequently for iron deficiency as well. This is because they not only have an increased risk of hospitalization and mortality, but also have a poor prognosis in terms of quality of life.
Source: “Iron deficiency in patients with heart failure”, 03.02.2021, Vifor Pharma.
Further reading:
- Ponikowski P, et al: AFFIRM-AHF investigators. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. Lancet 2020 Dec 12; 396(10266): 1895-19004.
CARDIOVASC 2021; 20(1): 31
