IRON-HF study: A randomized trial to assess the effects of iron in heart failure patients with anemia
IRON-HF study: A randomized trial to assess the effects of iron in heart failure patients with anemia
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DOI：
10.1016/j.ijcard.2013.04.181
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发表时间：
2013-10-09
影响因子：
3.5
通讯作者：
Clausell, Nadine
中科院分区：
文献类型：
--
作者：
Beck-da-Silva, Luis;Piardi, Diogo;Clausell, Nadine
背景：心力衰竭患者的贫血与发病率和死亡率增加有关。以前的研究已经单独或联合使用促红细胞生成素和静脉（IV）铁治疗心力衰竭患者的贫血。然而，仅静脉或口服（PO）补铁对心力衰竭伴贫血患者的影响尚不清楚。目的：在双盲设计中比较静脉注射铁与静脉注射铁对贫血性心力衰竭患者的影响。方法：铁hf研究是一项多中心、研究者发起、随机、双盲、安慰剂对照试验，纳入了肾功能保留、低转铁蛋白饱和度（TSat）和低至中度铁蛋白水平升高的贫血性心力衰竭患者。干预措施为蔗糖铁静脉注射200 mg，每周一次，持续5周，硫酸亚铁200 mg PO TID，持续8周，或安慰剂。主要终点是在3个月的随访中通过肺活量计评估的峰值耗氧量（峰值VO2）的变化。结果：18例患者随访资料完整。IV铁组VO2峰值增加3.5 ml/kg/min。PO铁组的峰值VO2没有增加。两组患者的铁蛋白和TSat均显著升高。血红蛋白在所有组中都有相似的增加。结论：静脉注射铁在改善心力衰竭患者的功能能力方面具有优势。然而，对贫血的纠正似乎至少在静脉补铁和静脉补铁之间是相似的。2013爱思唯尔爱尔兰有限公司版权所有。
Background: Anemia in heart failure patients and has been associated with increased morbi-mortality. Previous studies have treated anemia in heart failure patients with either erythropoietin alone or combination of erythropoietin and intravenous (IV) iron. However, the effect of IV or oral (PO) iron supplementation alone in heart failure patients with anemia was virtually unknown.Aim: To compare, in a double-blind design, the effects of IV iron versus PO iron in anemic heart failure patients. Methods: IRON-HF study was a multicenter, investigator initiated, randomized, double-blind, placebo controlled trial that enrolled anemic heart failure patients with preserved renal function, low transferrin saturation (TSat) and low-to-moderately elevated ferritin levels. Interventions were Iron Sucrose IV 200 mg, once a week, for 5 weeks, ferrous sulfate 200 mg PO TID, for 8 weeks, or placebo. Primary endpoint was variation of peak oxygen consumption (peak VO2) assessed by ergospirometry over 3 month follow-up.Results: Eighteen patients had full follow-up data. There was an increment of 3.5 ml/kg/min in peak VO2 in the IV iron group. There was no increment in peak VO2 in the PO iron group. Patients' ferritin and TSat increased significantly in both treated groups. Hemoglobin increased similarly in all groups.Conclusion: IV iron seems to be superior in improving functional capacity of heart failure patients. However, correction of anemia seems to be at least similar between PO iron and IV iron supplementation. (C) 2013 Elsevier Ireland Ltd. All rights reserved.