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Table 1
Laboratory Tests to Diagnose Iron Deficiency Anemia in Heart Failure Patients
| Laboratory Test | |
|---|---|
| CBC | • Red cell indices • Reticulocyte count • Evaluation of peripheral blood smear |
| Iron studies | • Serum iron • Transferrin • Iron saturation • Ferritin • Total iron binding capacity |
| Renal fucntion | • Serum creatinine • Creatinine clearance |
| Inflammatory factors | • CRP • ESR |
| Vitamin B | • Vitamin B12 • Folate |
| Hormones | • TSH |
CBC-complete blood count; CRP=C-reactive protein; ESR=erythrocyte sedimentation rate
Nunez-Gil IJ, Peraira-Moral JR. Anaemia in heart failure: intravenous iron therapy. European Society of Cardiology. E-Journal of Cardiology Practice. 2012;10:16.
Table 2
Laboratory Findings Associated with Iron Deficiency Anemia
| Laboratory Parameter | Result |
|---|---|
| Hemoglobin | • <13g/dL (men) • <12g/dL (women) |
| Mean corpuscular volume (MCV) | • Low |
| Serum Ferritin | • Low: <100ng/mL (absolute iron deficiency) • Normal: 100-300ng/mL (functional iron deficiency) |
| Transferrin saturation (Tsat) | • <20% accompanied by normal ferritin = functional iron deficiency |
Table 3
Recommendations of Consensus Guidelines for Iron Supplementation in Patients with HF
| Guideline | Recommendation |
|---|---|
| 2016 European Society of Cardiology Guidelines | Intravenous FCM should be considered in symptomatic patients with HFrEF and iron deficiency (serum ferritin <100ng/L or ferritin between 100-299ng/L and transferrin saturation <20%) in order to alleviate HF symptoms and improve exercise capacity and quality of life |
| 2017 American Heart Association/American College of Cardiology (AHA/ACC) Guideline Recommendations | In patients with NYHA class II and III HF and iron deficiency (ferritin <100ng/mL or 100-300ng/mL if transferrin saturation is <20%), intravenous iron replacement might be reasonable to improve functional status and QoL. |
FCM=ferric carboxymaltose; HF=heart failure; HFrEF=heart failure with reduced ejection fraction; QoL=quality of life
Ponikowski P, et al. Eur Heart J. 2016 Jul 14;37(27):2129-200.
Yancy CW, et al. Circulation. 2017 Aug 8;136(6):e137-e161.
This article originally appeared on MPR
