Intravenous iron therapy in patients with heart failure. A double-edged sword

摘要

We read with interest the article of Beck-da-Silva et al., who recently concluded that intravenous (IV) iron seems to be superior over oral supplementation for improving functional capacity of heart failure patients [1]. Irrespective of the study design, involving comparison of functional outcomes between two different means of iron supplementation, we raise some clinical issues about the rationale underlying this investigation.According to the data published by Beck-da-Silva et al., the modest number of patients (n = 23) enrolled in this multicenter investigation had moderate anemia (i.e., hemoglobin concentration comprised between 90 and 120 g/L) but no evidence of iron deficiency, which would be the only plausible reason supporting whatever form of iron administration in these patients [ 1 ]. The mean ferritin value of the entire cohort of patients (132 ± 138 ug/L) was comprised within the current reference range of the healthy population for this parameter (i.e., 30-300ug/L for males and 15-200 ug/L for females, respectively).