Oral Iron Therapy in Chronic Heart Failure Patients

Inclusion criteria

• Both gender patients aged over 18 years;
• Diagnosis of chronic heart failure (identified by the use of Framingham criteria) for ≥ 6 months;
• New York Heart Association functional class II and III;
• Left ventricular ejection fraction ≤ 45%
• Regular attendance in an outpatient Heart Failure Clinic;
• Adequate therapeutic drug for heart failure syndrome based on beta-adrenergic blocker, angiotensin converting enzyme inhibitor or angiotensin receptor blocker, and mineralocorticoid receptor blocker;
• Evidence of iron deficiency in biochemical analyses: ferritin values < 100 ng/dL or between 100 ng/dL and 300 ng/dL, with transferrin saturation < 20%;
• Hemoglobin value between 9,0 - 16 g/dL;
• Provide written informed consent.

Exclusion criteria

• Recent device implant (in the last 3 months) or perspective of device implantation (conventional or multisite pacing) in the next 6 months;
• Known active infection, inflammatory disease or C-reactive protein > 20 mg/dL
• Immunosuppressive therapy;
• In use of erythropoietin and/or current treatment with oral or intravenous iron;
• Clinically bleeding or blood transfusion in previous 3 months;
• Renal failure on dialysis;
• Hemoglobinopathies, hemochromatosis or active malignancy;
• Unstable angina pectoris or clinically significant uncorrected valvular disease, except mitral and tricuspid regurgitation secondary to ventricular dilatation;
• Acute myocardial infarction or acute coronary syndrome, transient ischaemic attack within the last 3 months;
• Uncontrolled arterial hypertension;
• Evidence of comorbidity that features active systemic disease, i.e. liver disease, collagen disease and untreated hyperthyroidism or hypothyroidism;
• Pregnant or lactating women;
• Anaemia due to reasons other than iron deficiency (i.e. vitamin B12 deficiency);
• Recent admission for decompensated heart failure (last 3 months).