Should Patients with Heart Failure “Pump” Iron?

Anemia is common and associated with adverse outcomes in patients with heart failure. Iron deficiency is also common in heart failure, sometimes in the absence of frank anemia. Although results of small trials suggest benefits of iron supplementation for iron deficiency in heart failure patients, definitive evidence has been lacking.

In the manufacturer-sponsored FAIR-HF trial, 459 patients with systolic heart failure, iron deficiency, and NYHA class II–III symptoms were randomized in a 2:1 ratio to receive intravenous ferric carboxymaltose or placebo. Notably, half of the patients had normal baseline hemoglobin levels, and patients with clinically significant renal dysfunction were excluded. Participants were treated for 24 weeks: weekly un…