Abstract 17546: Effect of Intravenous Ferric Carboxymaltose on Symptoms and Quality of Life in Iron-Deficient Patients With Chronic Heart Failure With and Without Anemia: A Sub-Analysis of the FAIR-HF Trial
Background: Therapy with intravenous iron in patients with chronic heart failure (CHF) and iron deficiency improves symptoms, functional capacity and quality of life. We sought to investigate whether the presence of anemia at treatment onset affects these beneficial outcomes.
Methods: FAIR-HF randomized 459 patients with chronic heart failure (New York Heart Association [NYHA] class II or III, left ventricular ejection fraction ≤40% [for NYHA II] or ≤45% [for NYHA III]) and iron deficiency to intravenous iron as ferric carboxymaltose (FCM) or placebo in a 2:1 ratio. We analyzed the study's primary and secondary efficacy end-points according to the presence or absence of anemia (hemoglobin concentration ≤120g/L) at baseline.
Results: Of 459 patients, 232 had anemia at baseline (51%).
At week 24, the effect of FCM on the primary end points of self-reported Patient Global Assessment (PGA) and NYHA class (adjusted for baseline class was similar in patients with and without anemia; for PGA, the odd ratios (OR) and 95% confidence intervals (CI) were 2.48 (1.49, 4.14) for anemic and 2.60 (1.55, 4.35) for non-anemic patients, respectively, (p=0.98 for interaction). For NYHA class, OR and 95% CI were 1.90 (1.06, 3.40) for anemic and 3.39 (1.70, 6.75) for non-anemic patients (p=0.51). The effect of FCM on the secondary end points was the same in patients with or without anemia.
Conclusions: Treatment of iron deficiency with intravenous ferric carboxymaltose in patients with CHF is symptomatically effective irrespective of anemia suggesting that mechanisms other than erythropoesis are affected. Therefore, iron status should be assessed in all CHF patients regardless of the presence of anemia.
- © 2010 by American Heart Association, Inc.