Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study
Abstract
:1. Introduction
Aim of the Study
2. Methods
2.1. Outcomes
2.2. Statistical Analysis
3. Results
Baseline Characteristics
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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(n = 90) | With ID (n = 73) | Without ID (n = 17) | p Value | |
---|---|---|---|---|
Sex, n (%) | 0.2120 | |||
Male | 57 (63.3) | 44 (60.3) | 13 (76.5) | |
Female | 33 (36.7) | 29 (39.7) | 4 (23.5) | |
Age (years), mean ± SD | 82.7 ± 9.7 | 82.9 ± 8.9 | 82.1 ± 12.7 | 0.7722 |
BMI, kg/m2, mean ± SD | 27.1 ± 5.9 | 26.9 ± 5.7 | 28.2 ± 6.9 | 0.4822 |
Barthel index, mean ± SD | 48.5 ± 25.5 | 49.1 ± 27.0 | 45.9 ± 18.6 | 0.6447 |
CCI, n (%) | 0.6928 | |||
0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
1 | 12 (13.5) | 9 (12.5) | 3 (17.7) | |
2+ | 77 (86.5) | 63 (87.5) | 14 (82.4) | |
Comorbidities, n (%) | ||||
Coronary artery disease | 46 (51.1) | 39 (53.4) | 7 (41.2) | 0.3629 |
Hypertension | 72 (80.0) | 57 (78.1) | 15 (88.2) | 0.5068 |
COPD | 45 (50.0) | 35 (48.0) | 10 (58.8) | 0.4191 |
Diabetes Mellitus | 35 (38.9) | 28 (38.4) | 7 (41.2) | 0.8299 |
Malignancy | 24 (26.7) | 20 (27.4) | 4 (23.5) | 1.0000 |
AF/AFL | 21 (23.3) | 17 (23.3) | 4 (23.5) | 1.0000 |
Chronic Kidney Disease | 16 (17.8) | 12 (16.4) | 4 (23.5) | 0.4925 |
Medications, n (%) | ||||
ACEi/ARB | 41 (45.6) | 34 (46.6) | 7 (41.2) | 0.6873 |
Betablockers | 55 (61.1) | 46 (63.0) | 9 (52.9) | 0.4429 |
Loop diuretics | 63 (70.0) | 52 (71.2) | 11 (64.7) | 0.5969 |
MRAs | 27 (30.0) | 21 (28.8) | 6 (35.3) | 0.5969 |
ARNi | 2 (2.2) | 0 (0.0) | 2 (11.8) | 0.0340 |
Digoxin | 3 (3.3) | 3 (4.7) | 0 (0.0) | 1.0000 |
Antiplatelets | 35 (38.9) | 30 (41.1) | 5 (29.4) | 0.3735 |
Anticoagulants | 52 (57.8) | 41 (56.2) | 11 (64.7) | 0.5215 |
NYHA, n (%) | 0.2427 | |||
1 | 3 (3.5) | 2 (2.8) | 1 (6.3) | |
2 | 15 (17.2) | 12 (16.9) | 3 (18.8) | |
3 | 34 (39.1) | 31 (43.7) | 3 (18.8) | |
4 | 35 (40.2) | 26 (36.6) | 9 (56.3) | |
mMRC, n (%) | 0.7758 | |||
1 | 1 (1.2) | 1 (1.5) | 0 (0.0) | |
2 | 3 (3.7) | 3 (4.5) | 0 (0.0) | |
3 | 6 (7.4) | 6 (9.0) | 0 (0.0) | |
4 | 16 (19.8) | 13 (19.4) | 3 (21.4) | |
5 | 38 (46.9) | 29 (43.3) | 9 (64.3) | |
6 | 17 (21.0) | 15 (22.4) | 2 (14.3) | |
LVEF, n (%) | 0.5573 | |||
>50% | 46 (53.5) | 39 (55.7) | 7 (43.8) | |
40–50% | 15 (17.5) | 13 (18.6) | 2 (12.5) | |
30–40% | 15 (17.4) | 11 (15.7) | 4 (25.0) | |
<30% | 10 (11.6) | 7 (10.0) | 3 (18.8) | |
LVEF, n (%) | 0.3867 | |||
>50% | 46 (53.5) | 39 (55.7) | 7 (43.8) | |
≤50% | 40 (46.5) | 31 (44.3) | 9 (56.3) | |
Hb (g/L), mean ±SD | 116.1 ± 20.3 | 113.4 ± 20.1 | 127.9 ± 17.0 | 0.0071 |
Hb < 120 (F) o <130 (M) g/L, n (%) | 60 (66.7) | 51 (69.9) | 9 (52.9) | 0.1825 |
BNP, ng/L, median (IQR) | 786 (458, 1500) | 801 (484, 1511) | 545 (275, 1463) | 0.1199 |
eGFR, ml/min/1.73 m2, median (IQR) | 50.5 (37.0, 65.4) | 49.8 (36.3, 64.0) | 64.0 (46.8, 81.6) | 0.1504 |
HbA1c, mmol/mol, median (IQR) | 44.0 (39.0, 52.0) | 45.0 (39.0, 52.0) | 42.5 (37.0, 48.0) | 0.2913 |
TSH, mIU/L, median (IQR) | 1.53 (0.91, 2.33) | 1.44 (0.88, 2.38) | 1.69 (1.20, 2.09) | 0.7245 |
Ferritin, ug/L, median (IQR) | 70.0 (34.0, 225.0) | 58.0 (27.0, 116) | 469.0 (299.0, 684) | <0.0001 |
Serum iron, umol/L, median (IQR) | 6.1 (4.3, 9.2) | 6.0 (4.2, 8.0) | 10.7 (7.1, 11.2) | 0.0037 |
TSAT, %, median (IQR) | 10.3 (7.1, 16.3) | 9.6 (6.0, 12.5) | 18.5 (12.3, 22.8) | 0.0005 |
(n = 73) | FCM Supplemented (n = 55) | FCM Unsupplemented (n = 18) | p Value | |
---|---|---|---|---|
Sex, n (%) | 0.2327 | |||
Male | 44 (60.3) | 31 (56.4) | 13 (72.2) | |
Female | 29 (39.7) | 24 (43.6) | 5 (27.8) | |
Age (years), mean ± SD | 82.9 ± 8.9 | 83.0 ± 8.4 | 82.6 ± 10.7 | 0.8618 |
BMI, kg/m2, mean ± SD | 26.9 ± 5.7 | 27.3 ± 6.0 | 25.9 ± 4.9 | 0.3873 |
Barthel index, mean ± SD | 49.1 ± 27.0 | 45.4 ± 25.6 | 60.9 ± 28.6 | 0.0377 |
CCI, n (%) | 1.0000 | |||
0 | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
1 | 9 (12.5) | 7 (12.7) | 2 (11.8) | |
2+ | 63 (87.5) | 48 (87.3) | 15 (88.2) | |
Comorbidities, n (%) | ||||
Coronary artery disease | 39 (53.4) | 28 (50.9) | 11 (61.1) | 0.4513 |
Hypertension | 57 (78.1) | 43 (78.2) | 14 (77.8) | 1.0000 |
COPD | 35 (48.0) | 30 (34.6) | 5 (27.8) | 0.0485 |
Diabetes Mellitus | 28 (38.4) | 23 (41.8) | 5 (27.8) | 0.2876 |
Malignancy | 20 (27.4) | 15 (27.3) | 5 (27.8) | 1.0000 |
AF/AFL | 17 (23.3) | 14 (25.5) | 3 (16.7) | 0.5361 |
Chronic Kidney Disease | 12 (16.4) | 8 (14.6) | 4 (22.2) | 0.4744 |
Medications, n (%) | ||||
ACEi/ARB | 34 (46.6) | 26 (47.3) | 8 (44.4) | 0.8346 |
Betablockers | 46 (63.0) | 37 (67.3) | 9 (50.0) | 0.1876 |
Loop diuretics | 52 (71.2) | 42 (76.4) | 10 (55.6) | 0.0905 |
MRAs | 21 (28.8) | 16 (29.1) | 5 (27.8) | 0.9149 |
ARNi | 0 (0.0) | 0 (0.0) | 0 (0.0) | -- |
Digoxin | 3 (4.7) | 3 (6.0) | 0 (0.0) | 1.0000 |
NYHA, n (%) | 0.7788 | |||
1 | 2 (2.8) | 1 (1.9) | 1 (5.9) | |
2 | 12 (16.9) | 9 (16.7) | 3 (17.7) | |
3 | 31 (43.7) | 24 (44.4) | 7 (41.2) | |
4 | 26 (36.6) | 20 (37.0) | 6 (35.3) | |
mMRC, n (%) | 0.6897 | |||
1 | 1 (1.5) | 1 (2.0) | 0 (0.0) | |
2 | 3 (4.5) | 2 (3.9) | 1 (6.3) | |
3 | 6 (9.0) | 5 (9.8) | 1 (6.3) | |
4 | 13 (19.4) | 8 (15.7) | 5 (31.3) | |
5 | 29 (43.3) | 24 (47.1) | 5 (31.3) | |
6 | 15 (22.4) | 11 (21.6) | 4 (25.0) | |
EF, n (%) | 0.1234 | |||
>50% | 39 (55.7) | 31 (58.5) | 8 (47.1) | |
40–50% | 13 (18.6) | 9 (17.0) | 4 (23.5) | |
30–40% | 11 (15.7) | 10 (18.9) | 1 (5.9) | |
<30% | 7 (10.0) | 3 (5.7) | 4 (23.5) | |
EF, n (%) | 0.4090 | |||
>50% | 39 (55.7) | 31 (58.5) | 8 (47.1) | |
≤50% | 31 (44.3) | 22 (41.5) | 9 (52.9) | |
Hb (g/L), mean ± SD | 113.4 ± 20.1 | 110.1 ± 20.7 | 123.4 ± 14.5 | 0.0136 |
Hb < 120 (F) o < 130 (M) g/L, n (%) | 51 (69.9) | 41 (74.6) | 10 (55.6) | 0.1275 |
BNP, ng/L, median (IQR) | 801 (484, 1511) | 798 (463, 1442) | 878 (526, 3775) | 0.2207 |
eGFR, ml/min/1.73 m2, median (IQR) | 49.8 (36.3, 64.0) | 49.3 (35.9, 64.8) | 50.3 (41.2, 63.2) | 0.7460 |
HbA1c, %, median (IQR) | 45.0 (39.0, 52.0) | 44.0 (39.0, 53.0) | 46.0 (42.0, 49.0) | 0.8174 |
TSH, mIU/L, median (IQR) | 1.44 (0.88, 2.38) | 1.35 (0.86, 2.19) | 1.89 (0.97, 3.00) | 0.2871 |
Ferritin, µg/L, median (IQR) | 58.0 (27.0, 116) | 51.5 (27.0, 104) | 93.0 (39.0, 143) | 0.2937 |
Serum iron, umol/L, median (IQR) | 6.0 (4.2, 8.0) | 5.8 (4.0, 6.8) | 8.1 (5.9, 10.3) | 0.0308 |
TSAT, %, median (IQR) | 9.6 (6.0, 12.5) | 8.7 (5.0, 11.6) | 12.8 (10.6, 19.6) | 0.0019 |
With ID (n = 67) | Without ID (n = 15) | p Value | FCM Supplemented (n = 52) | FCM Unsupplemented (n = 15) | p Value | |
---|---|---|---|---|---|---|
Death, n (%) | 13 (19.4) | 2 (13.3) | 0.7228 | 10 (19.2) | 3 (20.0) | 1.0000 |
All-cause readmissions, n (%) | 44 (65.7) | 11 (73.3) | 0.8150 | 34 (65.4) | 10 (66.7) | 0.9266 |
Readmissions for heart failure or cardiovascular events, n (%) | 31 (46.3) | 8 (53.3) | 0.7882 | 26 (50.0) | 5 (33.3) | 0.2541 |
LOS (days), median (Q1, Q3) | 9 (7, 13) | 9 (7, 13) | 0.4017 | 11 (8, 15) | 6 (5, 9) | 0.0002 |
Mean Differences within Group | Mean Differences between Groups (Follow-Up) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
FCM Supplemented | FCM Unsupplemented | ||||||||||
Admission (SE) | Follow-Up (SE) | Mean Difference (SE) | p Value | Admission (SE) | Follow-Up (SE) | Mean Difference (SE) | p Value | Mean Difference (SE) | p Value § | Effect Size d | |
Ferritin, ug/L | 143.8 (10.7) | 222.7 (17.4) | 78.9 (20.8) | 0.0015 | 180.7 (14.6) | 56.7 (22.4) | −124.0 (27.1) | <0.0001 | −166.1 (28.9) | <0.0001 | 0.63 |
TSAT, % | 10.7 (0.7) | 19.4 (1.2) | 8.7 (1.3) | <0.0001 | 12.8 (1.0) | 16.6 (1.6) | 3.7 (1.8) | 0.1576 | 2.8 (2.0) | 0.0268 | 0.65 |
Hb, g/L | 114.4 (1.5) | 128.3 (2.4) | 13.8 (3.0) | <0.0001 | 118.2 (2.0) | 120.9 (3.2) | 2.74 (3.9) | 0.8925 | 10.1 (3.3) | 0.0255 | 0.56 |
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Capone, F.; Cipriani, A.; Molinari, L.; Noale, M.; Gusella, B.; Lucente, F.; Savino, S.; Bertomoro, A.; Saller, A.; Giannini, S.; et al. Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study. J. Pers. Med. 2023, 13, 1250. https://doi.org/10.3390/jpm13081250
Capone F, Cipriani A, Molinari L, Noale M, Gusella B, Lucente F, Savino S, Bertomoro A, Saller A, Giannini S, et al. Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study. Journal of Personalized Medicine. 2023; 13(8):1250. https://doi.org/10.3390/jpm13081250
Chicago/Turabian StyleCapone, Federico, Alberto Cipriani, Leonardo Molinari, Marianna Noale, Beatrice Gusella, Fabrizio Lucente, Sandro Savino, Antonella Bertomoro, Alois Saller, Sandro Giannini, and et al. 2023. "Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study" Journal of Personalized Medicine 13, no. 8: 1250. https://doi.org/10.3390/jpm13081250
APA StyleCapone, F., Cipriani, A., Molinari, L., Noale, M., Gusella, B., Lucente, F., Savino, S., Bertomoro, A., Saller, A., Giannini, S., & Vettor, R. (2023). Ferric Carboxymaltose in Patients with Acute Decompensated Heart Failure and Iron Deficiency: A Real-Life Study. Journal of Personalized Medicine, 13(8), 1250. https://doi.org/10.3390/jpm13081250