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Studies have confirmed that up to 40%-70% of patients with chronic heart failure suffer from iron deficiency.
Regardless of anemia, iron deficiency is associated with decreased motor function, impaired health-related quality of life, and poor prognosis (including cardiovascular mortality).
Timely diagnosis and treatment of iron deficiency in patients with heart failure can help improve heart failure symptoms, quality of life and prognosis.
Yimaitong compiles and organizes, please do not reprint without authorization.
How much do you know about the treatment of iron deficiency in patients with heart failure? Come and test it now! 01 Regarding the assessment of iron status in patients with heart failure, which of the following statements is correct? A.
Patients with newly diagnosed heart failure do not need to undergo routine iron deficiency tests.
B.
Routine iron deficiency tests are only recommended for patients with reduced left ventricular ejection fraction (LVEF).
C.
Chronic symptoms that are still symptomatic after optimal heart failure treatment Heart failure is not an indication for iron assessment.
D.
Patients with chronic heart failure should undergo iron status assessment 1-2 times a year.
Figure 1 Red blood cell analysis of iron deficiency: According to the guidelines of the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) / American Heart Association (AHA) joint guidelines, all newly diagnosed heart failure patients should be tested for iron status.
When a patient is iron deficient, appropriate treatment should be started.
ESC recommends that clinicians conduct 1-2 assessments of iron status in patients with chronic heart failure every year.
In addition, clinicians should consider evaluating the iron status of patients with chronic heart failure who still have symptoms after receiving the best heart failure drugs.
Answer: D02 is correct for the treatment of iron deficiency in patients with heart failure? A.
Parenteral iron should be avoided for treatment B.
Mean red blood cell volume is a reliable marker of patient response to iron treatment C.
Patients with thalassemia can be safely treated with iron supplementation D.
When medical care is taken, iron deficiency should be clarified first Diagnosis and analysis of underlying causes: For patients with iron deficiency and heart failure, the diagnosis and cause of iron deficiency must first be clarified during medical care. In most cases, the treatment of iron deficiency should start with oral iron supplementation and correct the underlying cause of iron deficiency to prevent its recurrence.
Parenteral iron therapy is an option for patients to treat iron deficiency.
It can be used for patients who cannot absorb oral iron or who are still anemia despite adequate oral iron treatment.
However, compared with oral iron, parenteral iron therapy is more costly and has a higher incidence of adverse reactions.
Average red blood cell volume is an advanced marker of iron deficiency, but it has not been proven to be a reliable marker of treatment response.
Patients with small cell anemia with iron overload should not be treated with iron, such as thalassemia and sideroblastic anemia.
Answer: D03.
Which of the following statements is correct for the treatment of iron deficiency in patients with heart failure? A.
Iron deficiency treatment is only needed when the patient develops anemia.
B.
Patients with chronic heart failure have a better tolerance to oral iron.
C.
Ferritin levels are less than 100 ng/mL, or between 100-300 ng/mL In patients with TSAT <20%, intravenous iron supplementation should be considered.
D.
For patients with hemoglobin level> 15g/dL, intravenous iron supplementation is safe and effective analysis: ferritin level <100 ng/mL, or between 100-300 ng In patients with heart failure between mL/mL and TSAT<20%, intravenous iron supplementation can be considered to improve the patient's functional status and quality of life.
Regardless of whether they are suffering from anemia, iron-deficient heart failure patients should be treated with iron supplementation.
In some patients with heart failure, iron deficiency is more serious.
Even if the patient does not have anemia, it will aggravate the underlying disease and have a negative impact on the patient's symptoms, quality of life, exercise capacity, and clinical outcome.
Studies conducted in patients with stable systolic heart failure found that iron deficiency is an independent predictor of death or heart transplantation regardless of the presence of anemia.
Although oral iron supplementation is poorly tolerated and the incidence of gastrointestinal adverse reactions is as high as 60%, it is usually the first-line treatment for patients with iron-deficiency heart failure.
There is no study to evaluate the efficacy and safety of intravenous iron supplementation in patients with hemoglobin levels> 15g/dL, so it is not recommended to use it in such patients.
Answer: C04 How long should I reassess the iron status of patients with heart failure after starting intravenous iron replacement therapy? A.
3-6 months after treatment B.
1 month after treatment C.
Within 6-8 weeks after infusion D.
Analysis within 8-10 weeks after infusion: Although no prospective studies have confirmed the initiation of intravenous iron replacement therapy How long should the patient’s iron status be reassessed, but it is generally believed that it is beneficial to reassess the patient’s iron status after about 3-6 months of treatment.
Answer: A05 is correct for the treatment of iron deficiency in patients with heart failure? A.
Do not inject large doses of intravenous iron.
B.
Erythropoietin drugs are effective alternatives to iron replacement therapy.
C.
It is best to take oral iron 30-60 minutes after a meal.
D.
One-time iron provided by certain intravenous irons Analysis of higher content than other iron agents: At present, there are many intravenous iron preparations available, including iron(III) gluconate, iron(III) sucrose, iron(III) sucrose complex, iron(III) carboxyl group Maltose complex (ferric carboxymaltose) and nano-iron oxide (ferumoxytol).
Among them, iron sucrose, ferric hydroxide carboxymaltose complex and nano-iron oxide are new types of iron preparations.
Compared with traditional iron preparations, it can provide a higher dose of iron at one time.
Most studies on patients with heart failure and iron deficiency use iron sucrose (maximum dose: 200 mg/time) or ferric hydroxide carboxymaltose complex (maximum dose: 1000 mg/time).
Intravenous iron can be administered either as a simplified dose pill injection or via infusion.
The CONFIRM-HF test yielded a positive result.
In the study, iron is a pill that can be injected intravenously quickly without obvious safety issues.
Due to the lack of benefit, the ACC/AHA guidelines do not recommend the use of erythropoietin drugs in patients with heart failure with anemia to improve morbidity and mortality.
It is recommended that patients take iron orally 30-60 minutes before meals.
This is mainly because the absorption rate of iron is the highest in the fasting state. Answer: D Yimaitong compiled from: Jeffrey J.
Hsu.
Fast Five Quiz: Management of Iron Deficiency in Heart Failure.
Medscape.
March 03, 2021.
Regardless of anemia, iron deficiency is associated with decreased motor function, impaired health-related quality of life, and poor prognosis (including cardiovascular mortality).
Timely diagnosis and treatment of iron deficiency in patients with heart failure can help improve heart failure symptoms, quality of life and prognosis.
Yimaitong compiles and organizes, please do not reprint without authorization.
How much do you know about the treatment of iron deficiency in patients with heart failure? Come and test it now! 01 Regarding the assessment of iron status in patients with heart failure, which of the following statements is correct? A.
Patients with newly diagnosed heart failure do not need to undergo routine iron deficiency tests.
B.
Routine iron deficiency tests are only recommended for patients with reduced left ventricular ejection fraction (LVEF).
C.
Chronic symptoms that are still symptomatic after optimal heart failure treatment Heart failure is not an indication for iron assessment.
D.
Patients with chronic heart failure should undergo iron status assessment 1-2 times a year.
Figure 1 Red blood cell analysis of iron deficiency: According to the guidelines of the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) / American Heart Association (AHA) joint guidelines, all newly diagnosed heart failure patients should be tested for iron status.
When a patient is iron deficient, appropriate treatment should be started.
ESC recommends that clinicians conduct 1-2 assessments of iron status in patients with chronic heart failure every year.
In addition, clinicians should consider evaluating the iron status of patients with chronic heart failure who still have symptoms after receiving the best heart failure drugs.
Answer: D02 is correct for the treatment of iron deficiency in patients with heart failure? A.
Parenteral iron should be avoided for treatment B.
Mean red blood cell volume is a reliable marker of patient response to iron treatment C.
Patients with thalassemia can be safely treated with iron supplementation D.
When medical care is taken, iron deficiency should be clarified first Diagnosis and analysis of underlying causes: For patients with iron deficiency and heart failure, the diagnosis and cause of iron deficiency must first be clarified during medical care. In most cases, the treatment of iron deficiency should start with oral iron supplementation and correct the underlying cause of iron deficiency to prevent its recurrence.
Parenteral iron therapy is an option for patients to treat iron deficiency.
It can be used for patients who cannot absorb oral iron or who are still anemia despite adequate oral iron treatment.
However, compared with oral iron, parenteral iron therapy is more costly and has a higher incidence of adverse reactions.
Average red blood cell volume is an advanced marker of iron deficiency, but it has not been proven to be a reliable marker of treatment response.
Patients with small cell anemia with iron overload should not be treated with iron, such as thalassemia and sideroblastic anemia.
Answer: D03.
Which of the following statements is correct for the treatment of iron deficiency in patients with heart failure? A.
Iron deficiency treatment is only needed when the patient develops anemia.
B.
Patients with chronic heart failure have a better tolerance to oral iron.
C.
Ferritin levels are less than 100 ng/mL, or between 100-300 ng/mL In patients with TSAT <20%, intravenous iron supplementation should be considered.
D.
For patients with hemoglobin level> 15g/dL, intravenous iron supplementation is safe and effective analysis: ferritin level <100 ng/mL, or between 100-300 ng In patients with heart failure between mL/mL and TSAT<20%, intravenous iron supplementation can be considered to improve the patient's functional status and quality of life.
Regardless of whether they are suffering from anemia, iron-deficient heart failure patients should be treated with iron supplementation.
In some patients with heart failure, iron deficiency is more serious.
Even if the patient does not have anemia, it will aggravate the underlying disease and have a negative impact on the patient's symptoms, quality of life, exercise capacity, and clinical outcome.
Studies conducted in patients with stable systolic heart failure found that iron deficiency is an independent predictor of death or heart transplantation regardless of the presence of anemia.
Although oral iron supplementation is poorly tolerated and the incidence of gastrointestinal adverse reactions is as high as 60%, it is usually the first-line treatment for patients with iron-deficiency heart failure.
There is no study to evaluate the efficacy and safety of intravenous iron supplementation in patients with hemoglobin levels> 15g/dL, so it is not recommended to use it in such patients.
Answer: C04 How long should I reassess the iron status of patients with heart failure after starting intravenous iron replacement therapy? A.
3-6 months after treatment B.
1 month after treatment C.
Within 6-8 weeks after infusion D.
Analysis within 8-10 weeks after infusion: Although no prospective studies have confirmed the initiation of intravenous iron replacement therapy How long should the patient’s iron status be reassessed, but it is generally believed that it is beneficial to reassess the patient’s iron status after about 3-6 months of treatment.
Answer: A05 is correct for the treatment of iron deficiency in patients with heart failure? A.
Do not inject large doses of intravenous iron.
B.
Erythropoietin drugs are effective alternatives to iron replacement therapy.
C.
It is best to take oral iron 30-60 minutes after a meal.
D.
One-time iron provided by certain intravenous irons Analysis of higher content than other iron agents: At present, there are many intravenous iron preparations available, including iron(III) gluconate, iron(III) sucrose, iron(III) sucrose complex, iron(III) carboxyl group Maltose complex (ferric carboxymaltose) and nano-iron oxide (ferumoxytol).
Among them, iron sucrose, ferric hydroxide carboxymaltose complex and nano-iron oxide are new types of iron preparations.
Compared with traditional iron preparations, it can provide a higher dose of iron at one time.
Most studies on patients with heart failure and iron deficiency use iron sucrose (maximum dose: 200 mg/time) or ferric hydroxide carboxymaltose complex (maximum dose: 1000 mg/time).
Intravenous iron can be administered either as a simplified dose pill injection or via infusion.
The CONFIRM-HF test yielded a positive result.
In the study, iron is a pill that can be injected intravenously quickly without obvious safety issues.
Due to the lack of benefit, the ACC/AHA guidelines do not recommend the use of erythropoietin drugs in patients with heart failure with anemia to improve morbidity and mortality.
It is recommended that patients take iron orally 30-60 minutes before meals.
This is mainly because the absorption rate of iron is the highest in the fasting state. Answer: D Yimaitong compiled from: Jeffrey J.
Hsu.
Fast Five Quiz: Management of Iron Deficiency in Heart Failure.
Medscape.
March 03, 2021.
