Short-Term Intravenous Iron Therapy with Ferric Carboxy-Sucrose versus Oral Iron in Patients with Symptomatic Heart Failure with Reduced Ejection Fraction and Iron Deficiency

To evaluate the efficiency and safety of short-term I.V. iron therapy with ferric carboxy sucrose versus oral iron with ferrous glycine sulfate complex therapy in heart failure (HF) with reduced ejection fraction patients with iron deficiency. A randomized clinical trial on a total of 50 stable HFrEF patients (mean age 50 ±11.6 years) were enrolled in the study between October 2018 to April 2020. The patients were recruited from Cardiology outpatient clinic & inpatient Cardiology department, Beni- Suef University hospital. (25 patients) received oral ferrous glycine sulfate complex and (25 patients) received IV ferric carboxy sucrose. All patients were subjected to; recording of demographic data, full clinical examination, and laboratory and imaging investigations and six-minute walk test (6MWT). Results showed that apart from EF, all parameters improved significantly after iron therapy (regardless of route of therapy) as regards LVED, LVES, serum iron, serum ferritin, transferrin saturation, 6MWT & NYHA classification. There was a significant negative correlation between the improvement of transferrin saturation & the NYHA classification after intravenous iron therapy. There was a significant weak positive correlation between iron improvement & 6MWT improvement in all 50 patients. Also, a trend towards a weak positive correlation between iron improvement by intravenous route & improvement of 6 MWT was observed. Regardless the route of administration, iron therapy (I.V. iron therapy in the form of ferric carboxy-sucrose or oral iron in the form of ferrous glycine sulfate complex) is safe & effective in improving functional capacity of HFrEF patients with iron deficiency. This improvement is proportional to the degree of improvement in transferring saturation obtained by IV ferric carboxy-sucrose therapy.