Determinants of ineligibility for intravenous iron therapy in patients with heart failure and LVEF <45%: a retrospective cohort study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F25%3AE0112145" target="_blank" >RIV/00843989:_____/25:E0112145 - isvavai.cz</a>

Alternative codes found

RIV/61988987:17110/25:A2603DG8

Result on the web

<a href="https://www.e-coretvasa.cz/pdfs/cor/2025/06/01.pdf" target="_blank" >https://www.e-coretvasa.cz/pdfs/cor/2025/06/01.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.33678/cor.2025.093" target="_blank" >10.33678/cor.2025.093</a>

Result language

angličtina

Original language name

Determinants of ineligibility for intravenous iron therapy in patients with heart failure and LVEF <45%: a retrospective cohort study

Original language description

Background: Intravenous iron therapy improves symptoms and reduces hospitalizations in patients with heart failure (HF) and iron deficiency (ID). Clinical trials evaluating this therapy have often excluded patients with higher hemoglobin (HGB) levels, although current European Society of Cardiology guidelines do not specify an upper HGB limit. This study aimed to assess how HGB thresholds influence eligibility for intravenous iron among real-world HF patients with left ventricular ejection fraction (LVEF) < 45%. Methods: We retrospectively analyzed consecutive patients attending a specialized HF outpatient clinic in 2024. ID was defined as ferritin < 100 µg/L, or 100-299 µg/L with transferrin saturation (TSAT) < 20%. Eligibility for intravenous iron was simulated using various HGB thresholds ranging from ?150 g/L to ?160 g/L. Clinical and laboratory characteristics of eligible and non-eligible patients were compared. Results: Among 176 patients with LVEF < 45%, 98 (55.7%) fulfilled ID criteria. Using an HGB threshold of ?150 g/L, only 29.5% of patients were eligible for intravenous iron. Increasing the threshold to 155 g/L and 160 g/L would expand eligibility to 38.1% and 46.7%, respectively. Patients excluded based on higher HGB levels often exhibited functional ID and elevated NT-proBNP, indicating advanced HF. All patients who met the eligibility criteria during the study period received intravenous iron. Conclusion: A substantial proportion of HF patients with LVEF < 45% and clinically relevant ID may be excluded from intravenous iron therapy based on HGB levels, despite current guidelines not imposing a strict cutoff. A modest increase in the HGB threshold may allow more symptomatic patients to benefit from guideline-recommended treatment.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Cor et Vasa

ISSN

0010-8650

e-ISSN

1803-7712

Volume of the periodical

67

Issue of the periodical within the volume

6

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

6

Pages from-to

671-676

UT code for WoS article

001644058600001

EID of the result in the Scopus database

—