IV Sodium Ferric Gluconate Complex in Patients Admitted due to Acute Decompansated Heart Failure and Iron Deficiency

Background

Patients suffering from heart failure (HF) and iron deficiency (ID) have worse outcomes. Intra-venous (IV) ferric carboxymaltose has been shown to reduce HF readmissions and improve symptoms in patients with HF with reduced ejection fraction. However, IV ferric carboxymaltose is significantly more expensive than IV Sodium Ferric Gluconate Complex limiting it’s availability to most HF failure patients around the globe.

Methods

A retrospective analysis comparing patients admitted due to acute decompensated HF (ADHF) and treated with or without IV sodium ferric gluconate complex on top of standard medical therapy. The study included all patients admitted due to ADHF, with either reduced or preserved EF between January 2013 to December 2018. During the study period, a total of 1856 patients were admitted due to ADHF to internal ward or cardiology department. Among them 840 patients had an indication for IV iron therapy according to ESC guidelines and met the inclusion and exclusion criteria.

Results

Among 840 patients, only 122 (14.5%) patients were treated with IV Sodium Ferric Gluconate during hospitalization. When comparing the group of patients treated with IV iron with the group that was treated with only standard HF treatment without IV Iron group, at one year after the hospitalization there was no deference regarding reduction in readmissions for HF (27.9% vs 24.8% respectively P = 0.54 ), nor difference in all-cause mortality (25.4% vs. 25.6% respectively, P = 0.99 ).

Conclusion

Use of IV Sodium ferric gluconate complex during hospitalization due to ADHF did not show any advantage in reduction of readmission due to heart failure after 1 year follow up.