| Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency FERRIC-HF: a randomized, controlled, observer-blinded trial. | |
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MedLine Citation:
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PMID: 18191732 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We tested the hypothesis that intravenous iron improves exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure (CHF) and iron deficiency. BACKGROUND: Anemia is common in heart failure. Iron metabolism is disturbed, and administration of iron might improve both symptoms and exercise tolerance. METHODS: We randomized 35 patients with CHF (age 64 +/- 13 years, peak oxygen consumption [pVO2] 14.0 +/- 2.7 ml/kg/min) to 16 weeks of intravenous iron (200 mg weekly until ferritin >500 ng/ml, 200 mg monthly thereafter) or no treatment in a 2:1 ratio. Ferritin was required to be <100 ng/ml or ferritin 100 to 300 ng/ml with transferrin saturation <20%. Patients were stratified according to hemoglobin levels (<12.5 g/dl [anemic group] vs. 12.5 to 14.5 g/dl [nonanemic group]). The observer-blinded primary end point was the change in absolute pVO2. RESULTS: The difference (95% confidence interval [CI]) in the mean changes from baseline to end of study between the iron and control groups was 273 (151 to 396) ng/ml for ferritin (p < 0.0001), 0.1 (-0.8 to 0.9) g/dl for hemoglobin (p = 0.9), 96 (-12 to 205) ml/min for absolute pVO2 (p = 0.08), 2.2 (0.5 to 4.0) ml/kg/min for pVO2/kg (p = 0.01), 60 (-6 to 126) s for treadmill exercise duration (p = 0.08), -0.6 (-0.9 to -0.2) for New York Heart Association (NYHA) functional class (p = 0.007), and 1.7 (0.7 to 2.6) for patient global assessment (p = 0.002). In anemic patients (n = 18), the difference (95% CI) was 204 (31 to 378) ml/min for absolute pVO2 (p = 0.02), and 3.9 (1.1 to 6.8) ml/kg/min for pVO2/kg (p = 0.01). In nonanemic patients, NYHA functional class improved (p = 0.06). Adverse events were similar. CONCLUSIONS: Intravenous iron loading improved exercise capacity and symptoms in patients with CHF and evidence of abnormal iron metabolism. Benefits were more evident in anemic patients. (Effect of Intravenous Ferrous Sucrose on Exercise Capacity in Chronic Heart Failure; http://www.clinicaltrials.gov/ct/show/NCT00125996; NCT00125996). |
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Authors:
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Darlington O Okonko; Agnieszka Grzeslo; Tomasz Witkowski; Amit K J Mandal; Robert M Slater; Michael Roughton; Gabor Foldes; Thomas Thum; Jacek Majda; Waldemar Banasiak; Constantinos G Missouris; Philip A Poole-Wilson; Stefan D Anker; Piotr Ponikowski |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 51 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-14 Completed Date: 2008-02-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 103-12 Citation Subset: AIM; IM |
Affiliation:
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Clinical Cardiology, NHLI, Imperial College London, London, United Kingdom. d.okonko@imperial.ac.uk |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00125996 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Anemia, Iron-Deficiency / complications, diagnosis, drug therapy*, mortality Chronic Disease Confidence Intervals Dose-Response Relationship, Drug Double-Blind Method Drug Administration Schedule Exercise Tolerance / drug effects* Female Ferric Compounds / administration & dosage* Follow-Up Studies Heart Failure / complications, diagnosis, drug therapy*, mortality Humans Infusions, Intravenous Male Middle Aged Oxygen Consumption / drug effects*, physiology Probability Prospective Studies Reference Values Risk Assessment Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Ferric Compounds |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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