الفهرس | Only 14 pages are availabe for public view |
Abstract Objective: To evaluate the efficiency and safety of short-term I.V. iron therapy with ferric carboxy sucrose versus oral iron with ferrous glycine sulfate complex therapy in heart failure (HF) with reduced ejection fraction patients with iron deficiency. Patients and methods: a randomized clinical trial on a total of 50 stable HFrEF patients (mean age 50 ±11.6 years) were enrolled in the study between October 2018 to April 2020. The patients were recruited from Cardiology outpatient clinic & inpatient Cardiology department, Beni-Suef University hospital. (25 patients) received oral ferrous glycine sulfate complex and (25 patients) received IV ferric carboxy sucrose. All patients were subjected to; recording of demographic data, full clinical examination, and laboratory and imaging investigations and six-minute walk test (6MWT). Results: Results showed that apart from EF, all parameters improved significantly after iron therapy (regardless of route of therapy) as regards LVED, LVES, serum iron, serum ferritin, transferrin saturation, 6MWT & NYHA classification. There was a significant negative correlation between the improvement of transferrin saturation & the NYHA classification after intravenous iron therapy. There was a significant weak positive correlation between iron improvement & 6MWT improvement in all 50 patients. Also, a trend towards a weak positive correlation between iron improvement by intravenous route & improvement of 6 MWT was observed. Conclusion: Regardless the route of administration, iron therapy (I.V. iron therapy in the form of ferric carboxy-sucrose or oral iron in the form of ferrous glycine sulfate complex) is safe & effective in improving functional capacity of HFrEF patients with iron deficiency. This improvement is proportional to the degree of improvement in transferrin saturation obtained by IV ferric carboxy-sucrose therapy. Oral iron might be equivalent to IV iron in the management of iron deficiency HF patients. These findings suggest that iron therapy (regardless rout of administration) may potentially represent a beneficial addition to the standard medical management of HF. An adequately powered RCT is needed to confirm these findings. Keywords: Iron deficiency, Heart failure, Iron sucrose, Intravenous Iron, Oral Iron, Clinical trial. |