Iron deficiency, heart failure and cerebrovascular events: what is the connection?

Abstract

Heart failure (HF) is the leading cause of hospitalization among patients aged 65 years and older. One of the most common comorbidities in HF is iron deficiency (ID), being present in about 50% of all HF patients. ID in HF has been shown to reduce exercise capacity, increase the risk of cerebrovascular events, and increase patient morbidity and mortality. The association between heart failure with reduced ejection fraction (HFrEF) and ID has already been proven to lead to an increased risk of cardiovascular events, and some research is establishing a similar relation between heart failure with preserved ejection fraction (HFpEF) and ID. ID can lead to hypercoagulability, which in HF may be associated with an increased risk of stroke/TIA (transient ischemic attack). Although current HF treatment guidelines recognize ID as a significant problem, ID is still rarely recognized and undertreated.