Oral Iron Repletion for Patients with Heart Failure?

Iron deficiency is common in patients with heart failure (HF) and is associated with adverse outcomes, including death and functional impairment. Intravenous (IV) iron replacement can benefit patients with symptomatic systolic HF and iron deficiency, even those without anemia (NEJM JW Cardiol Jan 2010 and N Engl J Med 2009; 361:2436). Because IV iron is both inconvenient and expensive, understanding the efficacy of oral iron replacement is important. In the randomized, 16-week IRONOUT-HF trial, researchers compared oral iron polysaccharide 150 mg twice daily and placebo in 225 patients with symptomatic systolic HF (median age, 63; 36% women, median left ventricular ejection fraction, 25%), objectively determined iron deficiency, and hemoglo…