Kaminsky Bonnie M, Pogue Kristen T, Hanigan Sarah, Koelling Todd M, Dorsch Michael P
Department of Pharmacy, University of Michigan Health System, Ann Arbor, Michigan; Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan.
Department of Pharmacy, University of Michigan Health System, Ann Arbor, Michigan; Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
Am J Cardiol. 2016 Jun 15;117(12):1942-6. doi: 10.1016/j.amjcard.2016.03.041. Epub 2016 Apr 29.
Iron deficiency is common in heart failure (HF), and intravenous (IV) iron therapy has been associated with improved clinical status in ambulatory patients with HF. There are limited data to support the safety and efficacy of IV iron administration in patients with acute HF. This was a retrospective cohort study of patients admitted to the University of Michigan Health System for HF with low iron studies during admission. Patients were grouped based on the receipt of IV iron therapy. Study outcomes included change in hemoglobin, 30-day readmission, and adverse events. Forty-four patients who received IV iron and 128 control patients were identified. The mean dose of IV iron received was 1,057 (±336) mg. IV iron resulted in a significantly greater increase in hemoglobin over time (p = 0.0001). The mean change in hemoglobin in the iron and control groups was 0.74 g/dl and 0.01 g/dl at day 7 and 2.61 g/dl and 0.23 g/dl at day 28, respectively. Thirty-day readmission rates were 30% and 22% for patients in the iron and control groups, respectively (p = 0.2787). In conclusion, total dose infusion IV iron is well tolerated and associated with significant improvement in hemoglobin in acute HF.
缺铁在心力衰竭（HF）中很常见，静脉注射（IV）铁剂治疗已被证实可改善非卧床HF患者的临床状况。关于急性HF患者静脉注射铁剂的安全性和有效性的数据有限。这是一项回顾性队列研究，研究对象为因HF入住密歇根大学卫生系统且入院时铁指标较低的患者。患者根据是否接受静脉铁剂治疗进行分组。研究结果包括血红蛋白变化、30天再入院率和不良事件。共确定了44例接受静脉铁剂治疗的患者和128例对照患者。接受静脉铁剂的平均剂量为1057（±336）mg。随着时间的推移，静脉铁剂导致血红蛋白显著增加（p = 0.0001）。铁剂组和对照组在第7天血红蛋白的平均变化分别为0.74 g/dl和0.01 g/dl，在第28天分别为2.61 g/dl和0.23 g/dl。铁剂组和对照组患者的30天再入院率分别为30%和22%（p = 0.2787）。总之，急性HF患者静脉输注全剂量铁剂耐受性良好，且与血红蛋白显著改善相关。
