Heart failure is the most common reason for hospitalisation in Germany. The disease often has a severe course; 25 percent of the patients die within the first year of being diagnosed. In addition to causing distress to the affected persons, heart failure generates high costs in the health care system. Various studies claim that iron deficiency is a co-morbidity in 35 to 60 percent of patients suffering from heart failure. Iron deficiency causes two problems: on the one hand, iron is essential for providing the cells of the body with energy, while on the other hand the blood cells are unable to transport sufficient oxygen. This results in tiredness, a drop in performance and disturbed concentration. On the whole, the body is more susceptible to diseases.
In the FAIR-HF 2 study, the team of DZHK researchers around Prof. Stefan Anker (University Medical Centre Göttingen) and Dr. Mahir Karakas (University Heart Centre Hamburg) will be assessing whether treatment with intravenously administered ferric carboxymaltose improves the chances of survival and helps to reduce the number of hospitalisations of heart failure patients diagnosed with iron deficiency. "Previous studies have already demonstrated that the symptoms of heart failure and the quality of life of iron deficiency patients can be improved by correcting the iron deficiency", said Dr. Mahir Karakas. The findings also suggest that this therapy decreases the frequency of hospital stays related to heart failure. "However, until now this has never been studied systematically in a randomised, placebo-controlled study."
1,200 patients diagnosed with at least moderate heart failure are to be enrolled in the current DZHK study. Within the DZHK study the patients will be divided into two groups. The first group will receive regular ferric carboxymaltose infusions, while the second group will receive saline infusions. "The infusions are very well tolerated and the iron contained therein is rapidly absorbed by the body. Ferric carboxymaltose is a so-called high-dose preparation. This means that two infusions at most are sufficient to completely replenish the iron stores. That is why we chose this preparation", the researchers said. Generally, the researchers are expecting to see a class effect; this means that the results can probably be transferred to other intravenously administered iron preparations.
"Should the findings confirm our hypothesis that iron therapy increases the survival of heart failure patients and reduces the number of hospital stays, this result will be incorporated in the therapy guidelines", the physicians stated. If this is the case, every patient suffering from heart failure and iron deficiency should receive an appropriate intravenous therapy, which has not necessarily been the case until now. For many heart failure patients, this would considerably improve their prognosis.
Scientific study title: Intravenous iron in patients with systolic heart failure and iron deficiency to improve morbidity & mortality – FAIR–HF 2
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