Physicians' Academy for Cardiovascular Education

Low testing rates for iron deficiency in patients with HF

Phenotyping heart failure patients for iron deficiency and use of intravenous iron therapy: data from the Swedish Heart Failure Registry

Literature - Becher PM, Schrage B, Benson L et al. - Eur J Heart Fail. 2021 Sep 3. doi: 10.1002/ejhf.2338.

Introduction and methods

Iron deficiency (ID) is associated with high risk of hospitalizations and mortality in patients with HF [1]. This study investigated the likelihood and predictors of being tested for ID, the prevalence and outcomes of ID, and the use of ferric carboxymaltose (FCM) in the Swedish Heart Failure Registry (SwedeHF) [2].

The study included all patients enrolled in SwedeHF between 1 January 2017 and 31 December 2018 (n=21496). ID was defined as ferritin<100 µg/L, or ferritin 100-299 µg/L and transferrin saturation <20%. Anemia was defined as hemoglobin <12.0 g/dL in women and <13 g/dL in men. Patients without data on ferritin or transferrin saturation were considered as not being tested for ID. Baseline characteristics were compared across patients with vs. without ID and with vs. without anemia. Additionally, Baseline characteristics were compared across patients tested vs. not tested for ID and receiving vs. not receiving FCM. Investigated outcomes were: the composite of time to first HF hospitalization or all-cause death, time to first HF hospitalization, time to all-cause death, time to first all-cause hospitalization, and time to first HF outpatient visit. Median follow-up was 19.4 (IQR 0.1-35.9) months.

Main results


In SwedeHF, approximately 1 in 4 patients with HF were tested for ID. ID was present in half of the tested population. 1 in 5 patients with ID received FCM.


Show references

Find this article online at Eur J Heart Fail.

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