Abstract 4141624: The inadequacy of Physician’s Knowledge of Iron Deficiency Anemia in Heart Failure

Introduction: It is estimated that about 30% of patients with heart failure (HF) have iron deficiency anemia that can be masked as chronic normocytic anemia or functional anemia. Currently, the ACC/AHA 2022 heart failure guidelines give IV Iron replacement a Class IIa recommendation. However, many physicians who are regularly involved in the management of HF patients do not assess for or adequately treat iron deficiency anemia in these patients. This project seeks to identify the gaps in physicians’ knowledge on iron deficiency anemia and HF. Method: Over a 2-week period, a 9-item questionnaire was given to a total of 52 Internal Medicine physicians: 9 attendings, 27 residents (2nd and 3rd year) and 16 interns (1st year residents) chosen by convenience sampling. The participants at that time, were regularly involved in the care of patients with HF at a Brooklyn inter-city community Hospital. Data was collected and analyzed using IBM SPSS version 29 data analysis software. Results: All 52 participants completed the survey. When asked if all stages and classification of heart failure can be affected by iron deficiency anemia, 81.3% of interns vs 100% of both residents and attendings answered yes. However, only 18.8% of interns, 22.2% of residents and 11.1% of attendings test every patient with HFrEF <40% for iron deficiency anemia. Even though over 90% of the physicians had managed patients admitted for HF within the prior 2 weeks. Remarkably, 81.3% of interns, 59.3% of residents and 44.4% of attendings were aware that anemia in HF is an independent predictor of worsening mortality and morbidity. Iron deficiency anemia in HF diagnostic criteria of Ferritin < 100µg/L or ferritin between 100-299 µg/L with transferrin saturation < 20%, was known by 31% of interns, 40.7% of residents and 56.6% of attendings. None of the interns while 11.1% of both residents and attendings knew the recommendation of IV ferric carboxymaltose as treatment for iron deficiency anemia in HF. Responses to Stages and classification were significant at P value of 0.028. Conclusion: Iron deficiency anemia in HF is common, however physicians, both within and post training, are unaware of the management of iron deficiency anemia according to the 2022 heart failure guidelines. the study's statistical power can be improved with increased participants. More physician education is needed on Iron Deficiency anemia and Heart Failure with aim of improving patient care.