What are the benefits of intravenous iron replacement for patients with NYHA class II and III HF and iron deficiency?
Intravenous iron replacement may improve functional status and quality of life in patients with NYHA class II and III HF and iron deficiency (ferritin <100 ng/mL or 100 to 300 ng/mL if transferrin saturation is <20%). The FAIR-HF (Ferric Carboxymaltose Assessment in Patients With Iron Deficiency and Chronic Heart Failure) trial and the CONFIRM-HF (Ferric Carboxymaltose Evaluation on Performance in Patients With Iron Deficiency in Combination with Chronic Heart Failure) trial have demonstrated improvements in NYHA class and functional capacity when iron deficiency is diagnosed and treated. A meta-analysis of 5 prospective controlled studies (631 patients) showed limited but statistically significant improvements in functional capacity and LVEF after intravenous iron treatment, but no reduction in mortality rate. 