Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700RB Groningen, The Netherlands.
Nat Rev Cardiol. 2011 May 31;8(9):485-93. doi: 10.1038/nrcardio.2011.77.
Anemia and iron deficiency are common in patients with heart failure (HF), and are associated with worse symptoms and adverse outcomes in this population. Although the two can occur together, anemia in HF is often not caused by iron deficiency, and iron deficiency can be present without causing anemia. Erythropoiesis-stimulating agents have been investigated extensively in the past few years and might be of benefit in patients with HF and anemia. However, concerns have arisen regarding the safety of erythropoiesis-stimulating agents in patients with chronic kidney disease and so the results of a large mortality trial are eagerly awaited to provide information on safety in patients with HF. Iron supplementation or replacement is a much older treatment option for patients with HF and anemia, but questions about the safety of intravenous iron, and absorption problems with oral formulations have prevented its widespread use to date. In the past few years, however, new data on the importance of iron deficiency in HF have become available, and a number of studies with intravenous iron have shown promising results. Therefore, this treatment approach is likely to become an attractive option for patients with HF and iron deficiency, both with and without anemia.
贫血和缺铁在心力衰竭（HF）患者中很常见，与该人群的症状恶化和不良预后相关。虽然两者可能同时发生，但 HF 中的贫血通常不是由缺铁引起的，而缺铁也可能存在而不引起贫血。过去几年，人们广泛研究了促红细胞生成素刺激剂，它们可能对 HF 和贫血患者有益。然而，人们对慢性肾脏病患者使用促红细胞生成素刺激剂的安全性产生了担忧，因此迫切需要一项大型死亡率试验的结果，以提供有关 HF 患者安全性的信息。铁补充或替代是 HF 和贫血患者的一种更为古老的治疗选择，但静脉铁的安全性问题以及口服制剂的吸收问题阻止了其广泛使用。然而，在过去几年中，关于 HF 中铁缺乏症重要性的新数据已经出现，并且一些静脉铁的研究已经显示出有希望的结果。因此，这种治疗方法很可能成为 HF 和缺铁患者（无论是否贫血）的一个有吸引力的选择。
