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Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study

Background: The correction of iron deficiency (ID) with ferric carboxymaltose (FCM) is a recommended intervention in heart failure (HF) with reduced ejection fraction. Our aim is to evaluate, in a real-life setting, the clinical significance of ID screening and FCM treatment in acute decompensated H...

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Autores principales: Capone, Federico, Cipriani, Alberto, Molinari, Leonardo, Noale, Marianna, Gusella, Beatrice, Lucente, Fabrizio, Savino, Sandro, Bertomoro, Antonella, Saller, Alois, Giannini, Sandro, Vettor, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455601/
https://www.ncbi.nlm.nih.gov/pubmed/37623500
http://dx.doi.org/10.3390/jpm13081250
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author Capone, Federico
Cipriani, Alberto
Molinari, Leonardo
Noale, Marianna
Gusella, Beatrice
Lucente, Fabrizio
Savino, Sandro
Bertomoro, Antonella
Saller, Alois
Giannini, Sandro
Vettor, Roberto
author_facet Capone, Federico
Cipriani, Alberto
Molinari, Leonardo
Noale, Marianna
Gusella, Beatrice
Lucente, Fabrizio
Savino, Sandro
Bertomoro, Antonella
Saller, Alois
Giannini, Sandro
Vettor, Roberto
author_sort Capone, Federico
collection PubMed
description Background: The correction of iron deficiency (ID) with ferric carboxymaltose (FCM) is a recommended intervention in heart failure (HF) with reduced ejection fraction. Our aim is to evaluate, in a real-life setting, the clinical significance of ID screening and FCM treatment in acute decompensated HF (ADHF). Methods: In a cohort of ADHF patients, the prevalence of ID and FCM administration were investigated. Among the 104 patients admitted for ADHF, in n = 90 (median age 84, 53.5% with preserved left ventricular ejection fraction—LVEF), a complete iron status evaluation was obtained. ID was detected in n = 73 (81.1%), 55 of whom were treated with in-hospital FCM. The target dose was reached in n = 13. Results: No significant differences were detected in terms of age, sex, comorbidities, or LVEF between the FCM-supplemented and -unsupplemented patients. During a median follow-up of 427 days (IQR 405–466) among the FCM-supplemented patients, only 14.5% received FCM after discharge; the mortality and rehospitalizations among FCM-supplemented and -unsupplemented patients were similar (p = ns). In a follow-up evaluation, ID was still present in 75.0% of the FCM-supplemented patients and in 69.2% of the unsupplemented patients (p = ns). Conclusions: In this real-life ADHF cohort, FCM was administered at lower-than-prescribed doses, thus having no impact on ID correction. The significance of our findings is that only achieving the target dose of FCM and pursuing outpatient treatment can correct ID and produce long-term clinical benefits.
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spelling pubmed-104556012023-08-26 Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study Capone, Federico Cipriani, Alberto Molinari, Leonardo Noale, Marianna Gusella, Beatrice Lucente, Fabrizio Savino, Sandro Bertomoro, Antonella Saller, Alois Giannini, Sandro Vettor, Roberto J Pers Med Article Background: The correction of iron deficiency (ID) with ferric carboxymaltose (FCM) is a recommended intervention in heart failure (HF) with reduced ejection fraction. Our aim is to evaluate, in a real-life setting, the clinical significance of ID screening and FCM treatment in acute decompensated HF (ADHF). Methods: In a cohort of ADHF patients, the prevalence of ID and FCM administration were investigated. Among the 104 patients admitted for ADHF, in n = 90 (median age 84, 53.5% with preserved left ventricular ejection fraction—LVEF), a complete iron status evaluation was obtained. ID was detected in n = 73 (81.1%), 55 of whom were treated with in-hospital FCM. The target dose was reached in n = 13. Results: No significant differences were detected in terms of age, sex, comorbidities, or LVEF between the FCM-supplemented and -unsupplemented patients. During a median follow-up of 427 days (IQR 405–466) among the FCM-supplemented patients, only 14.5% received FCM after discharge; the mortality and rehospitalizations among FCM-supplemented and -unsupplemented patients were similar (p = ns). In a follow-up evaluation, ID was still present in 75.0% of the FCM-supplemented patients and in 69.2% of the unsupplemented patients (p = ns). Conclusions: In this real-life ADHF cohort, FCM was administered at lower-than-prescribed doses, thus having no impact on ID correction. The significance of our findings is that only achieving the target dose of FCM and pursuing outpatient treatment can correct ID and produce long-term clinical benefits. MDPI 2023-08-12 /pmc/articles/PMC10455601/ /pubmed/37623500 http://dx.doi.org/10.3390/jpm13081250 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Capone, Federico
Cipriani, Alberto
Molinari, Leonardo
Noale, Marianna
Gusella, Beatrice
Lucente, Fabrizio
Savino, Sandro
Bertomoro, Antonella
Saller, Alois
Giannini, Sandro
Vettor, Roberto
Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title_full Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title_fullStr Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title_full_unstemmed Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title_short Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
title_sort ferric carboxymaltose in patients with acute decompensated heart failure and iron deficiency: a real-life study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455601/
https://www.ncbi.nlm.nih.gov/pubmed/37623500
http://dx.doi.org/10.3390/jpm13081250
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