Table 2.
Summary of previous studies using intravenous iron in patients with chronic heart failure
| Authors | n | Design | Inclusion (Hb, ferritin) | Regimen and total iron dose per protocol | Follow-up time | Key results |
|---|---|---|---|---|---|---|
| Bolger et al.31 | 16 | Open, no control | Hb ≤ 12 g/dL and Ferritin ≤ 400 ng/mL | Iron sucrose, maximum 1000 mg iron i.v. over a 17-day period (200 mg iron on Days 1, 3, 5, plus Days 15 and 17, if ferritin <400 ng/mL on day 12) | 3 months | ↑Hb |
| ↑QoL | ||||||
| ↑Exercise capacity (6MWD) | ||||||
| Toblli et al.32 | 40 | Double-blind, randomized, placebo-controlled | Hb < 12.5 g/dL for men; <11.5 g/dL for women | Iron sucrose, 200 mg iron i.v. weekly for 5 weeks (total 1000 mg iron) | 6 months | ↑Hb |
| Ferritin <100 ng/mL and/or TSAT ≤ 20% | ↑QoL | |||||
| ↑Exercise capacity (6MWD) | ||||||
| ↑LVEF | ||||||
| ↓Hospitalizations | ||||||
| ↓NYHA | ||||||
| ↑Renal function | ||||||
| ↓NT-proBNP level | ||||||
| Okonko et al.33 | 35 | Single blind, randomized, controlled | Hb < 12.5 g/dL (anaemic group) | Iron sucrose, 200 mg iron i.v. weekly until ferritin ≥500 ng/mL (correction phase), then 200 mg iron every 4 weeks (maintenance phase) to Week 16 | 4 months | ↓HF symptoms (PGA) |
| 12.5–14.5 g/dl (non-anaemic group) | Required iron dose calculated using Ganzoni formula: body weight (kg) × 2.4 × [15—patient's Hb (g/dl)] + 500 mg (for stores) | ↑Exercise tolerance (peak VO2) | ||||
| Ferritin <100 ng/mL or 100–300 ng/mL with TSAT < 20% | ↓NYHA | |||||
| ↓Fatigue score | ||||||
| Usmanov et al.34 | 32 | Open, no control | Hb < 11 g/dL | Iron sucrose, 100 mg iron i.v. three times weekly for 3 weeks, then once weekly for 23 weeks (total 3200 mg iron) | 6 months | ↑Hb |
| Ferritin not specified | ↓NYHA (in NYHA class III patients) | |||||
| Echocardiographic indices: ↓PWT, ↓ST (in NYHA class III), ↓LVESD, ↓LVESV, ↓LVEDD (in NYHA class III), ↓LVEDV, ↓LVMI, ↑LVEF (in NYHA class III) |
6MWT, 6 min walking distance; Hb, haemoglobin; HF, heart failure; i.v., intravenous; LV, left ventricular; LVEDD, left ventricular end-diastolic diameter; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter; LVESV, left ventricular end-systolic volume; LVMI, left ventricular mass index; NT-proBNP, NT-pro-brain natriuretic peptide; NYHA, New York Heart Association; PGA, Patient's Global Assessment; PWT, posterior wall thickness; QoL, quality of life; ST, septal thickness; TSAT, transferrin saturation; VO2, oxygen consumption.