Anemia and Iron Deficiency in Heart Failure

Abstract

Anemia and iron deficiency (ID) are common co-morbidities in chronic heart failure (CHF) patients and are both independently associated with increased morbidity and mortality. Anemia affects one of three CHF patients and ID is present in half of CHF patients. While the treatment of anemia remains a challenge, ID has become a valid treatment target. ID is diagnosed when ferritin is lower than 100 ng/l, or between 100 and 299 ng/l with concurrent transferrin saturation below 20%. Correction of ID in CHF patients with or without anemia was shown to be safe and efficacious. It improves exercise capacity, quality of life and reduces the need for heart failure dependent hospitalisations. Current international guidelines recommend testing of all CHF patients for ID. If ID is diagnosed, intravenous iron substitution is recommended.