Sustained Haematological and Cardiac Responses Following Intravenous Ferric Carboxymaltose in Iron-Deficient Heart Failure with Reduced Ejection Fraction: A 12-Month Prospective Observational Study

Abstract

Introduction: Iron deficiency is a prevalent comorbidity in heart failure with reduced ejection fraction (HFrEF), and significant in causing anaemia, reducing exercise performance, and heart failure pathology. Ferric carboxymaltose (FCM) intravenously administered can restore iron levels and is not dependent on the digestive system. The study aim to analyse the changes in various physiological parameters following the administration of FCM.

Method: The study was a prospective observational study was conducted among 103 adult patients of chronic symptomatic HFrEF (NYHA II-III, LVEF <40%) with iron deficiency at HIMS, Uttar Pradesh. Patients were underwent with the FCM through intravenous route along with the conventional treatment for heart failure. The hematological, iron, cardiac, and renal markers were measured at baseline and after 3, 6, and 12 months of follow-up.

Results: The result findings showed the mean values of haemoglobin at baseline were 10.0 ± 1.5 g/dL, ferritin 59 ± 41 ng/mL, TSAT 17.2 ± 6.3%, and LVEF 31.7 ± 4.5%. Following 12 months of therapy, haemoglobin increase to 12.2 ± 1.2 g/dL, ferritin 293 ± 75 ng/mL, TSAT 30.1 ± 6.5%, and LVEF 41.5 ± 5.8% (all p < 0.001). NT-proBNP reduced from 1905 to 1620 pg/mL, and NYHA III patients from 41 to 15.

Conclusion: The study concluded that the FCM therapy was related with the improved iron status, haemoglobin, LVEF, NT-proBNP, and functional class for 12 months, without the reduction in the renal parameters.

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