Prevalence of Iron Deficiency in Patients of Heart Failure with Reduced Ejection Fraction and Response to Injectable Iron Therapy- A Hospital Based Observational Study

Aim of the Study: To estimate the prevalence of iron deficiency in patients of heart failure with reduced ejection fraction & response to injectable iron therapy in patients with iron deficiency anemia in heart failure with reduced ejection fraction. Materials and Methods: 1000 patients with heart failure with reduced ejection fraction (HFrEF; left ventricular ejection fraction <40%) who met the prespecified inclusion and exclusion criteria were chosen. A detailed history was taken and clinical examination was performed. Peripheral venous blood was drawn, and a complete hemogram along with iron studies (iron, ferritin, transferrin saturation and total iron binding capacity) were performedResults: Prevalence of iron deficiency among patients of heart failure with reduced ejection fraction was 63%. Most of the patients (71.42%) had absolute iron deficiency whereas 28.57% cases had functional iron deficiency status. 520(82.53%) patients were found to be anemic and 110(17.46%) patients were non anemic   which was statistically significant, suggesting that the prevalence of iron deficiency was higher among all anaemic patients with heart failure with reduced ejection fraction, as compared to non-anaemic individuals. The use of injectable iron therapy   significantly improved the NYHA functional status among all the patients of heart failure with reduced ejection fraction.  Conclusion: Our study showed that there is a large burden of iron deficiency in patients of heart failure with reduced ejection fraction irrespective of anemia status. The correction of iron deficiency, irrespective of the presence or absence of concomitant anemia, improves the NYHA functional status and quality of life. It may therefore be prudent to assess and use iron status as a therapeutic target in all patients with heart failure even with normal hemoglobin levels.