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Vol 12, No 4 (2017)
Cardiology Investigation
Published online: 2017-09-19
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Anemia and iron deficiency in patients with heart failure — diagnostic and therapeutic management

Agata Tymińska, Piotr Sypień, Krzysztof Ozierański, Grzegorz Opolski
DOI: 10.5603/FC.2017.0077
·
Folia Cardiologica 2017;12(4):422-430.

open access

Vol 12, No 4 (2017)
Cardiology Investigation
Published online: 2017-09-19

Abstract

Chronic heart failure (HF) is a growing problem of highly developed countries. The latest guidelines of the European Society of Cardiology (ESC) on HF have stressed the need for diagnosis and treatment of risk factors and comorbidities that aggravate HF course and affect prognosis. Recently, the subject of numerous studies has included anemia and iron deficiency, which are highly prevalent in patients with HF. By definition, anemia is diagnosed at hemoglobin below 13.0 g/dL in men and 12.0 g/dL in women. In the course of HF many factors can lead to the development of anemia. While iron deficiency may occur independently of the presence of anemia, and independently may deteriorate the prognosis of HF patients. According to the ESC guidelines, iron deficiency in patients with HF is reported with serum ferritin below 100 μg/L or ferritin 100–299 μg/L with iron transferrin saturation below 20%. This article discusses the incidence of anemia, causes of its occurrence in HF, the importance of prognosis, as well as diagnostic and therapeutic options. Currently there are several forms of treatment for anemia. However, the only treatment with proven efficacy and safety is intravenous iron supplementation in symptomatic HF patients with reduced left ventricular ejection fraction associated with iron deficiency.

Abstract

Chronic heart failure (HF) is a growing problem of highly developed countries. The latest guidelines of the European Society of Cardiology (ESC) on HF have stressed the need for diagnosis and treatment of risk factors and comorbidities that aggravate HF course and affect prognosis. Recently, the subject of numerous studies has included anemia and iron deficiency, which are highly prevalent in patients with HF. By definition, anemia is diagnosed at hemoglobin below 13.0 g/dL in men and 12.0 g/dL in women. In the course of HF many factors can lead to the development of anemia. While iron deficiency may occur independently of the presence of anemia, and independently may deteriorate the prognosis of HF patients. According to the ESC guidelines, iron deficiency in patients with HF is reported with serum ferritin below 100 μg/L or ferritin 100–299 μg/L with iron transferrin saturation below 20%. This article discusses the incidence of anemia, causes of its occurrence in HF, the importance of prognosis, as well as diagnostic and therapeutic options. Currently there are several forms of treatment for anemia. However, the only treatment with proven efficacy and safety is intravenous iron supplementation in symptomatic HF patients with reduced left ventricular ejection fraction associated with iron deficiency.

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Keywords

anemia, iron deficiency, heart failure, treatment, diagnosis, prognosis

About this article
Title

Anemia and iron deficiency in patients with heart failure — diagnostic and therapeutic management

Journal

Folia Cardiologica

Issue

Vol 12, No 4 (2017)

Pages

422-430

Published online

2017-09-19

DOI

10.5603/FC.2017.0077

Bibliographic record

Folia Cardiologica 2017;12(4):422-430.

Keywords

anemia
iron deficiency
heart failure
treatment
diagnosis
prognosis

Authors

Agata Tymińska
Piotr Sypień
Krzysztof Ozierański
Grzegorz Opolski

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