Wienbergen Harm, Pfister Otmar, Hochadel Matthias, Michel Stephan, Bruder Oliver, Remppis Björn Andrew, Maeder Micha Tobias, Strasser Ruth, von Scheidt Wolfgang, Pauschinger Matthias, Senges Jochen, Hambrecht Rainer
Bremer Institut für Herz- und Kreislaufforschung am Klinikum Links der Weser, Bremen, Germany.
Universitätsspital Basel, Kardiologie, Basel, Switzerland.
Am J Cardiol. 2016 Dec 15;118(12):1875-1880. doi: 10.1016/j.amjcard.2016.08.081. Epub 2016 Sep 15.
Iron deficiency (ID) has been identified as an important co-morbidity in patients with heart failure (HF). Intravenous iron therapy reduced symptoms and rehospitalizations of iron-deficient patients with HF in randomized trials. The present multicenter study investigated the "real-world" management of iron status in patients with HF. Consecutive patients with HF and ejection fraction ≤40% were recruited and analyzed from December 2010 to October 2015 by 11 centers in Germany and Switzerland. Of 1,484 patients with HF, iron status was determined in only 923 patients (62.2%), despite participation of the centers in a registry focusing on ID and despite guideline recommendation to determine iron status. In patients with determined iron status, a prevalence of 54.7% (505 patients) for ID was observed. Iron therapy was performed in only 8.5% of the iron-deficient patients with HF; 2.6% were treated with intravenous iron therapy. The patients with iron therapy were characterized by a high rate of symptomatic HF and anemia. In conclusion, despite strong evidence of beneficial effects of iron therapy on symptoms and rehospitalizations, diagnostic and therapeutic efforts on ID in HF are low in the actual clinical practice, and the awareness to diagnose and treat ID in HF should be strongly enforced.
缺铁(ID)已被确认为心力衰竭(HF)患者的一种重要合并症。在随机试验中,静脉铁剂治疗可减轻缺铁性HF患者的症状并减少再次住院率。本多中心研究调查了HF患者铁状态的“真实世界”管理情况。2010年12月至2015年10月期间,德国和瑞士的11个中心招募并分析了连续的HF患者且射血分数≤40%。在1484例HF患者中,尽管各中心参与了一项关注ID的登记研究且有指南推荐测定铁状态,但仅923例患者(62.2%)测定了铁状态。在已测定铁状态的患者中,ID的患病率为54.7%(505例患者)。仅8.5%的缺铁性HF患者接受了铁剂治疗;2.6%接受了静脉铁剂治疗。接受铁剂治疗的患者具有症状性HF和贫血的高发生率。总之,尽管有充分证据表明铁剂治疗对症状和再次住院有有益作用,但在实际临床实践中,对HF患者ID的诊断和治疗力度较低,应大力加强对HF患者ID的诊断和治疗意识。