Management of iron deficiency in heart failure: Practical considerations and implementation of evidence-based iron supplementation

Authors

Kazuhiko Kido, West Virginia University School of Pharmacy, Morgantown, West Virginia, USA. Electronic address: kazuhiko.kido0322@gmail.com.
Craig J. Beavers, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA.
Kenneth Dulnuan, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Nadia Fida, Houston Methodist, Houston, Texas, USA.
Maya Guglin, Krannert Cardiovascular Research Center, Indiana University Health School of Medicine, Indianapolis, Indiana, USA.
Onyedika J. Ilonze, Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University, Indianapolis, Indiana, USA.
Robert J. Mentz, Duke University School of Medicine, Durham, North Carolina, USA.
Nikhil Narang, Advocate Health - MidwestFollow
Navin Rajagopalan, Division of Cardiology, University of Kentucky, Lexington, Kentucky, USA.
Bhavadharini Ramu, University of Minnesota, Minneapolis, Minnesota, USA.
Yasar Sattar, West Virginia University Medicine, Morgantown, West Virginia, USA.
George Sokos, West Virginia University Medicine, Morgantown, West Virginia, USA.
Ewa A. Jankowska, Wroclaw Medical University, Wroclaw, Poland.

Recommended Citation

Kido K, Beavers CJ, Dulnuan K, et al. Management of Iron Deficiency in Heart Failure: Practical Considerations and Implementation of Evidence-Based Iron Supplementation. JACC Heart Fail. Published online June 28, 2024. doi:10.1016/j.jchf.2024.05.014

Affiliations

Advocate Heart Institute, Oak Lawn

Abstract

Iron deficiency (ID) is present in approximately 50% of patients with heart failure (HF) and even higher prevalence rate up to 80% in post-acute HF setting. The current guidelines for HF recommend intravenous (IV) iron replacement in HF with reduced or mildly reduced ejection fraction and ID based on clinical trials showing improvements in quality of life and exercise capacity, and an overall treatment benefit for recurrent HF hospitalization. However, several barriers cause challenges in implementing IV iron supplementation in practice due, in part, to clinician knowledge gaps and limited resource availability to protocolize routine utilization in appropriate patients. Thus, the current review will discuss practical considerations in ID treatment, implementation of evidence-based ID treatment to improve regional health disparities with toolkits, inclusion/exclusion criteria of IV iron supplementation, and clinical controversies in ID treatment, as well as gaps in evidence and questions to be answered.

Document Type

Article

PubMed ID

39001744