Department of Pharmacy, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Pharmacy, 23515Methodist University Hospital, Memphis, TN, USA.
J Cardiovasc Pharmacol Ther. 2021 Jul;26(4):365-370. doi: 10.1177/1074248421989871. Epub 2021 Feb 9.
The ACC/AHA heart failure (HF) guidelines include a class IIb recommendation for intravenous (IV) iron replacement in patients with iron deficiency and New York Heart Association class II or III to improve functional status and quality of life. Several studies have addressed the use of IV iron formulations such as ferric carboxymaltose or iron sucrose in HF population; however, few studies focused on sodium ferric gluconate complex (SFGC).
To assess the safety and effectiveness of an IV SFGC administration protocol in patients hospitalized with HF.
A retrospective cohort study was conducted. We included patients admitted to the HF service from September 2017 to March 2018. The primary outcome was the frequency of adverse reactions. The secondary outcome was the odds of HF readmissions between the 2 groups (IV SFGC vs. control).
Of the 123 patients, 70 received IV iron (SFGC group) and 53 did not receive IV iron (control group). Five (7%) patients of the 70 in the SFGC group experienced adverse events, which included hypotension (n = 2, 2.8%), fever (n = 2, 2.8%) and myalgia (n = 2, 2.8%). Nine (12.8%) and 18 (25.7%) were readmitted within 30 days and 6 months respectively. In the control arm, 5 (9.4%) and 14 (26.4%) were admitted within 30 days and 6 months respectively. The odds of HF readmission at 30 days [OR 1.4 (95% CI: 0.45, 4.5)] and at 6 months [OR 0.96 (95% CI: 0.43, 2.2)] were similar in those who did not receive IV iron compared to those who received IV iron.
Sodium ferric gluconate complex given at an accelerated dosing schedule appears to provide a more efficient means to prescribe IV iron in the inpatient setting and is safe with a low frequency of hypotension, fevers, and myalgias.
ACC/AHA 心力衰竭（HF）指南包括 IIb 类推荐，即对于铁缺乏和纽约心脏协会（NYHA）心功能 II 或 III 级的患者，静脉（IV）铁补充可改善功能状态和生活质量。有几项研究探讨了 IV 铁制剂如羧基麦芽糖铁或蔗糖铁在 HF 人群中的应用；然而，很少有研究关注葡甲胺铁复合物（SFGC）。
评估 IV SFGC 给药方案在 HF 住院患者中的安全性和有效性。
进行了一项回顾性队列研究。我们纳入了 2017 年 9 月至 2018 年 3 月期间因 HF 入住 HF 病房的患者。主要结局是不良反应的发生频率。次要结局是两组（IV SFGC 组与对照组）之间 HF 再入院的比值比（OR）。
在 123 例患者中，70 例接受了 IV 铁（SFGC 组），53 例未接受 IV 铁（对照组）。SFGC 组 70 例患者中有 5 例（7%）出现不良反应，包括低血压（n=2，2.8%）、发热（n=2，2.8%）和肌痛（n=2，2.8%）。30 天内分别有 9 例（12.8%）和 18 例（25.7%）再入院，6 个月内分别有 5 例（9.4%）和 14 例（26.4%）再入院。在对照组中，30 天内和 6 个月内分别有 5 例（9.4%）和 14 例（26.4%）再入院。与未接受 IV 铁治疗的患者相比，30 天[OR 1.4（95%CI：0.45，4.5）]和 6 个月[OR 0.96（95%CI：0.43，2.2）]时 HF 再入院的 OR 相似。
在加速给药方案下给予葡甲胺铁复合物似乎提供了一种更有效的方法来规定住院患者的 IV 铁治疗，并且低血压、发热和肌痛的发生率较低，安全性较高。
