Iron Deficiency Anemia in Nigerians with Heart Failure (IDAN-HF): Therapeutic efficacy of iron replacement: An interventional study

Abstract

Background: Recent evidence has reported significant improvement in clinical profile, quality of life, and prognosis of heart failure subjects with iron replacement. Aims: This study aimed to determine the safety and outcome of parenteral iron replacement among heart failure subjects in Nigeria. Method: A randomized interventional study was done at the Cardiology Clinic of LAUTECH Teaching Hospital, Ogbomoso, Nigeria. One hundred and forty subjects with heart failure were recruited. Iron deficiency and anemia were determined according to standardized criteria. Parenteral iron dextran was administered to a block randomized group of 30 of those identified with iron deficiency and compared with controls. The primary outcome was the six minutes walk test (6 MWT) after 8 weeks while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score was used to assess the quality of life as a secondary outcome. Statistical analysis was done with the SPSS 20.0. P value <0.05 was taken as statistically significant. Results: Iron deficiency was present in 84 (60.0%) of all study participants. Iron dextran was fairly tolerated with mild to moderate adverse reactions reported in 7 (23.3%) subjects who had an iron infusion. Improvement in the 6 MWT distance (390.1 ± 92.6 vs. 156.9 ± 72.5 meters, P < 0.05) and the KCCQ score (84.5 ± 3.7 vs. 64.2 ± 12.5%, P < 0.05) among iron-deficient heart failure subjects who received iron dextran was significantly higher than those who did not receive the iron replacement. Functional classification according to the New York Heart Association (NYHA) profile and heart rate were also much improved after the iron replacement than those who did not receive it. Conclusion: Parenteral iron dextran therapy was fairly tolerated among heart failure subjects. Iron replacement is associated with improved quality of life, better temporal clinical profile, and functional classification among Nigerians with heart failure. Iron replacement therapy can be an additional therapeutic option in heart failure management among Africans to improve prognosis.