Iron deficiency in chronic heart failure: diagnostics and therapy are rarely performed in clinical practice. Results of the RAID-HF registry

Background: Recent trials as FAIR-HF demonstrated an improvement of symptoms and exercise capacity by iron therapy in patients with heart failure (HF) and iron deficiency (ID). We investigated the clinical efforts on diagnostics and therapy of ID in the current "real-world" management of HF-patients. Methods: EVITA-HF is a registry of consecutive patients with chronic HF and left ventricular ejection fraction ≤ 40%. There are 17 recruiting centers in Germany and Switzerland. The RAID-HF substudy focusses on diagnosis and therapy of ID in HF-patients. Results: From 10/2010 until 07/2012 1603 HF-patients were included, only 3.7% received iron therapy (oral or intravenous). Patients with iron therapy were older, in a higher NYHA-class and had lower hemoglobin levels (Table). Diagnostics on iron status (blood levels of iron, ferritin, transferrin saturation) were performed in 434 patients (27.1%) of all HF-patients. In the group of patients with known iron status 220 patients (50.7%) had ID (ID defined as ferritin levels < 100 ng/ml or 100-299 ng/ml, if transferrin saturation < 20%). View this table: Patients with vs. without iron therapy Conclusions: In the current management of HF-patients less than 5% receive iron therapy. In only ¼ of the patients diagnostic measurements of iron status are performed (in spite of participation in an iron registry). Until now diagnosis of ID rarely leads to the initiation of iron supplementation in clinical practice.