General cardiology

FAIR-HF shows benefits of treating iron depletion in heart failure

Patients with heart failure may be prone to the development of iron deficiency either as a consequence of depletion of iron stores, defective iron absorption, or the reduced availability of iron recycled in the reticuloendothelial system. Iron plays a key role in oxygen uptake, transport, and storage, and oxidative metabolism in the skeletal muscle, as well as being involved in erythropoiesis.

To test the hypothesis that correction of iron deficiency (defined by low serum ferritin and transferrin saturation) confers symptomatic benefit in patients with chronic heart failure, the FAIR-HF (Ferinject Assessment in Patients with Iron Deficiency and Chronic Heart Failure) investigators recruited 459 patients with NYHA class II or III heart failure with an ejection fraction below 45%. The trial was a multicentre, double-blind placebo controlled study that gave intravenous iron (ferric carboxymaltose, 200 mg) or placebo to patients with an initial haemoglobin level of <135 g/l. The initial treatment was for 8 to 12 weeks, depending on the patient's iron deficit, followed by treatment every 4 weeks up to a total of 26 weeks of treatment.

The results demonstrated both early and sustained benefits in the treatment arm for the study's two primary outcomes: an improvement in the self-reported Patient Global Assessment scale, and a decrease in …