Palabras clave
Deficiencia de hierro
anemia
ferritina
insuficiencia cardíaca (fuente DeCS).
anemia
ferritina
insuficiencia cardíaca (fuente DeCS).
Cómo citar
1.
Arocha Rodulfo JI, Navas Blanco T, Amair M. P, Gómez Berroterán R. Implicaciones clínicas de la deficiencia de hierro en la insuficiencia cardíaca y abordaje del tratamiento. Rev. Colomb. Nefrol. [Internet]. 11 de julio de 2016 [citado 3 de julio de 2024];3(1):26-40. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/238
Resumen
El déficit de hierro con o sin anemia está siendo reconocido cada vez más como una comorbilidad importante en los pacientes con insuficiencia cardíaca (IC). Aunque la deficiencia de hierro es fácilmente diagnosticada por medio de dos marcadores (ferritina sérica y saturación de transferrina), es subdiagnosticada en estos pacientes y pudiera afectar hasta el 50% de los mismos. Aun antes del inicio de la anemia, los pacientes con IC y déficit de hierro muestran disminución en el rendimiento físico y cognitivo, con una mala calidad de vida. Más aún, la deficiencia de hierro es un factor de riesgo, independiente de la anemia, de evolución desfavorable (muerte o trasplante cardíaco) en los pacientes con IC crónica. Varios estudios aleatorios controlados han mostrado mejoría en la capacidad de ejercicio, clase funcional de la New York Heart Association (NYHA) y calidad de vida, luego de la corrección del déficit de hierro. Diversos factores contribuyen al desarrollo de este déficit, incluyendo edad avanzada, falla renal, hemodilución, inflamación crónica y severidad de la IC. Una variedad de mecanismos se han postulado para explicar la asociación de déficit de hierro e IC, y su corrección, como un blanco terapéutico, está ganando una mayor atención.
Citas
1. Silverberg DS, Wexler D, Blum M, Iaina A. The cardio renal anemia syndrome: correcting anemia in patients with resistant congestive heart failure can improve both cardiac and renal function and reduce hospitalizations. Clin Nephrol. 2003;60 Suppl 1:S93–102.
2. Palazzuoli A, Ruocco G, Pellegrini M, De Gori C, Del Castillo G, Giordano N, et al. The role of erythropoietin stimulating agents in anemic patients with heart failure: solved and unresolved questions. Ther Clin Risk Manag. 2014;10:641–50.
3. Cohen-Solal A, Leclercq C, Deray G, Lasocki S, Zambrowski JJ, Mebazaa A, et al. Iron deficiency: an emerging therapeutic target in heart failure. Heart. 2014;100(18):1414–20.
4. Sawicki KT, Chang HC, Ardehali H. Role of heme in cardiovascular physiology and disease. J Am Heart Assoc. 2015;4(1):e001138.
5. Jankowska EA, von Haehling S, Anker SD, Macdougall IC, Ponikowski P. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives. Eur Heart J. 2013;34(11):816–29.
6. World Health Organization. Report of WHO/UNICEF/UNU consultation on indicators and strategies for iron deficiency and anemia programmes. In WHO/UNICEF/UNU Consultation. Geneva: WHO; 1999.
7. Cioccia AM, Hevia P. Papel de la hepcidina y la ferroportina en la regulación hormonal de la homeostasis del hierro. Vitae.ucv.ve. 2014 Jul-Sep;59. Disponible en: http://vitae.ucv.ve/pdfs/VITAE_5008.pdf
8. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991;325(5):293–302.
9. Anand IS, Kuskowski MA, Rector TS, Florea VG, Glazer RD, Hester A, et al: Anemia and change in hemoglobin over time related to mortality and morbidity in patients with chronic heart failure: results from Val-HeFT. Circulation. 2005;112:1121–7.
10. Komajda M, Anker SD, Charlesworth A, Okonko D, Metra M, Di Lenarda A, et al. The impact of new onset anaemia on morbidity and mortality in chronic heart failure: results from COMET. Eur Heart J. 2006;27:1440–6.
11. Groenveld HF, Januzzi JL, Damman K, van Wijngaarden J, Hillege HL, van Veldhuisen DJ, et al. Anemia and mortality in heart failure patients a systematic review and meta- nalysis. J Am Coll Cardiol. 2008;52:818–27.
12. Adams KF Jr, Piña IL, Ghali JK, Wagoner LE, Dunlap SH, Schwartz TA, et al. Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure. Am Heart J. 2009;158:965–71.
13. Tang YD, Katz SD. Anemia in chronic heart failure: prevalence, etiology, clinical correlates, and treatment options. Circulation. 2006;113:2454–61.
14. Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Borenstein J. Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. J Am Coll Cardiol. 2002;39:1780–6.
15. Von Haehling S, van Veldhuisen DJ, Roughton M, Babalis D, de Boer RA, Coats AJ, et al. Anaemia among patients with heart failure and preserved or reduced ejection fraction: results from the SENIORS study. Eur J Heart Fail. 2011;13:656–63.
16. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012 Jul;33(14):1787–847.
17. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):1495–1539. doi:10.1016/j.jacc.2013.05.020.
18. Macdougall IC, Canaud B, de Francisco AL, Filippatos G, Ponikowski P, Silverberg D, et al. Beyond the cardiorenal anaemia syndrome: recognizing the role of iron deficiency. Eur J Heart Fail. 2012;14(8):882–6.
19. Enjuanes C, Klip IT, Bruguera J, Cladellas M, Ponikowski P, Banasiak W, et al. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study. Int J Cardiol. 2014;174:268–75.
20. Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartmann O, Ponikowska B, et al. Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. J Card Fail. 2011;17:899–906.
21. Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartmann O, Ponikowska B, et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J. 2010;31(15):1872–80.
22. Klip IT, Comin-Colet J, Voors AA, Ponikowski P, Enjuanes C, Banasiak W, et al. Iron deficiency in chronic heart failure: an international pooled analysis. Am Heart J. 2013;165(4):575–82.
23. Fitzsimons S, Doughty RN. Iron deficiency in patients with heart failure. Eur Heart J. 2015;1:58–64.
24. Qaseem A, Humphrey LL, Fitterman N, Starkey M, Shekelle P. Treatment of anemia in patients with heart disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013 Dic 3;159(11):770–9.
25. Unger EF, Thompson AM, Blank MJ, Temple R. Erythropoiesis-stimulating agents—time for a reevaluation. N Engl J Med. 2010 Ene 21;362(3):189–92. doi: 10.1056/NEJMp0912328. Epub 2010 Ene 6.
26. Phrommintikul A, Haas SJ, Elsik M, Krum H. Mortality and target haemoglobin concentrations in anaemic patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Lancet. 2007 Feb 3;369(9559):381–8.
27. Van der Meer P, Groenveld HF, Januzzi Jr JL, van Veldhuisen DJ. Erythropoietin treatment in patients with chronic heart failure: a meta-analysis. Heart. 2009;95:1309–14.
28. Ngo K, Kotecha D, Walters JA, Manzano L, Palazzuoli A, van Veldhuisen DJ, et al. Erythropoiesis-stimulating agents for anemia in chronic heart failure patients. Cochrane Database Syst Rev. 2010 Ene 20;(1):CD007613. doi: 10.1002/14651858.CD007613.pub2.
29. Ghali JK, Anand IS, Abraham WT, Fonarow GC, Greenberg B, Krum H, et al. Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart ailure and anemia. Circulation. 2008 Ene 29;117(4):526–35. doi: 10.1161/CIRCULATIONAHA.107.698514. Epub 2008 Ene 14.
30. Swedberg K, Young JB, Anand IS, Cheng S, Desai AS, Diaz R, et al. Treatment of anemia with darbepoetin alfa in systolic heart failure. N Engl J Med. 2013 Mar 28;368(13):1210–9. doi: 10.1056/NEJMoa1214865. Epub 2013 Mar 10.
31. Bello NA, Lewis EF, Desai AS, Anand IS, Krum H, McMurray JJ, et al. Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease. Eur J Heart Fail. 2015;17:1201–7.
32. Cançado RD, Muñoz M. Intravenous iron therapy: how far have we come? Rev Bras Hematol Hemoter. 2011;33(6):461–9.
33. Auerbach M, Goodnough LT, Shander A. Iron: the new advances in therapy. Best Pract Res Clin Anaesthesiol. 2013;27:131–40.
34. Bolger AP, Bartlett FR, Penston HS, O'Leary J, Pollock N, Kaprielian R, et al. Intravenous iron alone for the treatment of anemia in patients with chronic heart failure. J Am Coll Cardiol. 2006 Sep 19;48(6):1225–7. Epub 2006 Ago 28.
35. Usmanov RI, Zueva EB, Silverberg DS, Shaked M. Intravenous iron without erythropoietin for the treatment of iron deficiency anemia in patients with moderate to severe congestive heart failure and chronic kidney insufficiency. J Nephrol. 2008 Mar-Abr;21(2):236–42.
36. Toblli JE, Lombraña A, Duarte P, Di Gennaro F. Intravenous iron reduces NT-pro-rain natriuretic peptide in anemic patients with chronic heart failure and renal insufficiency. Am Coll Cardiol. 2007 Oct 23;50(17):1657–65.
37. Okonko DO, Grzeslo A, Witkowski T, Mandal AK, Slater RM, Roughton M, et al. Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency FERRIC-HF: a randomized, controlled, observer-blinded trial. J Am Coll Cardiol. 2008 Ene 15;51(2):103–12. doi: 10.1016/j.jacc.2007.09.036.
38. Anker SD, Comin Colet J, Filippatos G, Willenheimer R, Dickstein K, Drexler H, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med. 2009;361:2436–48. doi: 10.1056/NEJMoa0908355.
39. Ponikowski P, Filippatos G, Colet JC, Willenheimer R, Dickstein K, Lüscher T, et al. The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study. Eur J Heart Fail. 2015;17(3):329–39.
40. Ponikowski P, van Veldhuisen DJ, Comin-Colet J, Ertl G, Komajda M, Mareev V, et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015;36(11):657–68.
41. Qian C, Wei B, Ding J, Wu H, Wang Y. The Efficacy and Safety of Iron Supplementation in Patients With Heart Failure and Iron Deficiency: A Systematic Review and Meta-analysis. Can J Cardiol. 2016;32:151–9.
42. Jankowska EA, Tkaczyszyn M, Suchocki T, Drozd M, von Haehling S, Doehner W, et al. Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials. Eur J Heart Fail. 2016 Ene 28. doi: 10.1002/ejhf.473.
43. Silverberg DS, Wexler D, Schwartz D. Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure? Int J Mol Sci. 2015;16(6):14056–74.
44. Filippatos G, Farmakis D, Colet JC, Dickstein K, Lüscher TF, Willenheimer R, et al. Intravenous ferric carboxymaltose in iron-deficient chronic heart failure patients with and without anaemia: a subanalysis of the FAIR-HF trial. Eur J Heart Fail. 2013;15(11):1267–76.
45. Stugiewicz M, Tkaczyszyn M, Kasztura M, Banasiak W, Ponikowski P, Jankowska EA. The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications. Eur J Heart Fail. 2016 Ene 21. doi: 10.1002/ejhf.467.
46. Haas JD, Brownlie T IV. Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J Nutr. 2001 Feb;131(2S-2):676S–88S.
47. Enjuanes C, Bruguera J, Grau M, Cladellas M, González G, Meroño O, et al. Estado del hierro en la insuficiencia cardiaca crónica: impacto en síntomas, clase funcional y capacidad de ejercicio submáxima. Rev Esp Cardiol. 2016;69(3):247–55.
48. Enjuanes C, Klip IT, Bruguera J, Cladellas M, Ponikowski P, Banasiak W, et al. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study. Int J Cardiol. 2014;174(2):268–75.
49. Rocca HP, Crijns HJ. Iron i.v. in heart failure: ready for implementation? Eur Heart J. 2015;36(11):645–7.
50. Ebner N, von Haehling S. Iron deficiency in heart failure: a practical guide. Nutrients. 2013;5(9):3730–9.
51. McDonagh T, Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral? Eur J Heart Fail. 2015;17(3):248–62.
52. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387:907–16.
53. Morhaim D, Auerbach M. Iron-deficiency anaemia in the Emergency Room: a new opportunity for the use of intravenous iron. Blood Transfus. 2016;14(2):91–2.
2. Palazzuoli A, Ruocco G, Pellegrini M, De Gori C, Del Castillo G, Giordano N, et al. The role of erythropoietin stimulating agents in anemic patients with heart failure: solved and unresolved questions. Ther Clin Risk Manag. 2014;10:641–50.
3. Cohen-Solal A, Leclercq C, Deray G, Lasocki S, Zambrowski JJ, Mebazaa A, et al. Iron deficiency: an emerging therapeutic target in heart failure. Heart. 2014;100(18):1414–20.
4. Sawicki KT, Chang HC, Ardehali H. Role of heme in cardiovascular physiology and disease. J Am Heart Assoc. 2015;4(1):e001138.
5. Jankowska EA, von Haehling S, Anker SD, Macdougall IC, Ponikowski P. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives. Eur Heart J. 2013;34(11):816–29.
6. World Health Organization. Report of WHO/UNICEF/UNU consultation on indicators and strategies for iron deficiency and anemia programmes. In WHO/UNICEF/UNU Consultation. Geneva: WHO; 1999.
7. Cioccia AM, Hevia P. Papel de la hepcidina y la ferroportina en la regulación hormonal de la homeostasis del hierro. Vitae.ucv.ve. 2014 Jul-Sep;59. Disponible en: http://vitae.ucv.ve/pdfs/VITAE_5008.pdf
8. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991;325(5):293–302.
9. Anand IS, Kuskowski MA, Rector TS, Florea VG, Glazer RD, Hester A, et al: Anemia and change in hemoglobin over time related to mortality and morbidity in patients with chronic heart failure: results from Val-HeFT. Circulation. 2005;112:1121–7.
10. Komajda M, Anker SD, Charlesworth A, Okonko D, Metra M, Di Lenarda A, et al. The impact of new onset anaemia on morbidity and mortality in chronic heart failure: results from COMET. Eur Heart J. 2006;27:1440–6.
11. Groenveld HF, Januzzi JL, Damman K, van Wijngaarden J, Hillege HL, van Veldhuisen DJ, et al. Anemia and mortality in heart failure patients a systematic review and meta- nalysis. J Am Coll Cardiol. 2008;52:818–27.
12. Adams KF Jr, Piña IL, Ghali JK, Wagoner LE, Dunlap SH, Schwartz TA, et al. Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure. Am Heart J. 2009;158:965–71.
13. Tang YD, Katz SD. Anemia in chronic heart failure: prevalence, etiology, clinical correlates, and treatment options. Circulation. 2006;113:2454–61.
14. Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Borenstein J. Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. J Am Coll Cardiol. 2002;39:1780–6.
15. Von Haehling S, van Veldhuisen DJ, Roughton M, Babalis D, de Boer RA, Coats AJ, et al. Anaemia among patients with heart failure and preserved or reduced ejection fraction: results from the SENIORS study. Eur J Heart Fail. 2011;13:656–63.
16. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012 Jul;33(14):1787–847.
17. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):1495–1539. doi:10.1016/j.jacc.2013.05.020.
18. Macdougall IC, Canaud B, de Francisco AL, Filippatos G, Ponikowski P, Silverberg D, et al. Beyond the cardiorenal anaemia syndrome: recognizing the role of iron deficiency. Eur J Heart Fail. 2012;14(8):882–6.
19. Enjuanes C, Klip IT, Bruguera J, Cladellas M, Ponikowski P, Banasiak W, et al. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study. Int J Cardiol. 2014;174:268–75.
20. Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartmann O, Ponikowska B, et al. Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure. J Card Fail. 2011;17:899–906.
21. Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartmann O, Ponikowska B, et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J. 2010;31(15):1872–80.
22. Klip IT, Comin-Colet J, Voors AA, Ponikowski P, Enjuanes C, Banasiak W, et al. Iron deficiency in chronic heart failure: an international pooled analysis. Am Heart J. 2013;165(4):575–82.
23. Fitzsimons S, Doughty RN. Iron deficiency in patients with heart failure. Eur Heart J. 2015;1:58–64.
24. Qaseem A, Humphrey LL, Fitterman N, Starkey M, Shekelle P. Treatment of anemia in patients with heart disease: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013 Dic 3;159(11):770–9.
25. Unger EF, Thompson AM, Blank MJ, Temple R. Erythropoiesis-stimulating agents—time for a reevaluation. N Engl J Med. 2010 Ene 21;362(3):189–92. doi: 10.1056/NEJMp0912328. Epub 2010 Ene 6.
26. Phrommintikul A, Haas SJ, Elsik M, Krum H. Mortality and target haemoglobin concentrations in anaemic patients with chronic kidney disease treated with erythropoietin: a meta-analysis. Lancet. 2007 Feb 3;369(9559):381–8.
27. Van der Meer P, Groenveld HF, Januzzi Jr JL, van Veldhuisen DJ. Erythropoietin treatment in patients with chronic heart failure: a meta-analysis. Heart. 2009;95:1309–14.
28. Ngo K, Kotecha D, Walters JA, Manzano L, Palazzuoli A, van Veldhuisen DJ, et al. Erythropoiesis-stimulating agents for anemia in chronic heart failure patients. Cochrane Database Syst Rev. 2010 Ene 20;(1):CD007613. doi: 10.1002/14651858.CD007613.pub2.
29. Ghali JK, Anand IS, Abraham WT, Fonarow GC, Greenberg B, Krum H, et al. Randomized double-blind trial of darbepoetin alfa in patients with symptomatic heart ailure and anemia. Circulation. 2008 Ene 29;117(4):526–35. doi: 10.1161/CIRCULATIONAHA.107.698514. Epub 2008 Ene 14.
30. Swedberg K, Young JB, Anand IS, Cheng S, Desai AS, Diaz R, et al. Treatment of anemia with darbepoetin alfa in systolic heart failure. N Engl J Med. 2013 Mar 28;368(13):1210–9. doi: 10.1056/NEJMoa1214865. Epub 2013 Mar 10.
31. Bello NA, Lewis EF, Desai AS, Anand IS, Krum H, McMurray JJ, et al. Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease. Eur J Heart Fail. 2015;17:1201–7.
32. Cançado RD, Muñoz M. Intravenous iron therapy: how far have we come? Rev Bras Hematol Hemoter. 2011;33(6):461–9.
33. Auerbach M, Goodnough LT, Shander A. Iron: the new advances in therapy. Best Pract Res Clin Anaesthesiol. 2013;27:131–40.
34. Bolger AP, Bartlett FR, Penston HS, O'Leary J, Pollock N, Kaprielian R, et al. Intravenous iron alone for the treatment of anemia in patients with chronic heart failure. J Am Coll Cardiol. 2006 Sep 19;48(6):1225–7. Epub 2006 Ago 28.
35. Usmanov RI, Zueva EB, Silverberg DS, Shaked M. Intravenous iron without erythropoietin for the treatment of iron deficiency anemia in patients with moderate to severe congestive heart failure and chronic kidney insufficiency. J Nephrol. 2008 Mar-Abr;21(2):236–42.
36. Toblli JE, Lombraña A, Duarte P, Di Gennaro F. Intravenous iron reduces NT-pro-rain natriuretic peptide in anemic patients with chronic heart failure and renal insufficiency. Am Coll Cardiol. 2007 Oct 23;50(17):1657–65.
37. Okonko DO, Grzeslo A, Witkowski T, Mandal AK, Slater RM, Roughton M, et al. Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency FERRIC-HF: a randomized, controlled, observer-blinded trial. J Am Coll Cardiol. 2008 Ene 15;51(2):103–12. doi: 10.1016/j.jacc.2007.09.036.
38. Anker SD, Comin Colet J, Filippatos G, Willenheimer R, Dickstein K, Drexler H, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med. 2009;361:2436–48. doi: 10.1056/NEJMoa0908355.
39. Ponikowski P, Filippatos G, Colet JC, Willenheimer R, Dickstein K, Lüscher T, et al. The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study. Eur J Heart Fail. 2015;17(3):329–39.
40. Ponikowski P, van Veldhuisen DJ, Comin-Colet J, Ertl G, Komajda M, Mareev V, et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015;36(11):657–68.
41. Qian C, Wei B, Ding J, Wu H, Wang Y. The Efficacy and Safety of Iron Supplementation in Patients With Heart Failure and Iron Deficiency: A Systematic Review and Meta-analysis. Can J Cardiol. 2016;32:151–9.
42. Jankowska EA, Tkaczyszyn M, Suchocki T, Drozd M, von Haehling S, Doehner W, et al. Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials. Eur J Heart Fail. 2016 Ene 28. doi: 10.1002/ejhf.473.
43. Silverberg DS, Wexler D, Schwartz D. Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure? Int J Mol Sci. 2015;16(6):14056–74.
44. Filippatos G, Farmakis D, Colet JC, Dickstein K, Lüscher TF, Willenheimer R, et al. Intravenous ferric carboxymaltose in iron-deficient chronic heart failure patients with and without anaemia: a subanalysis of the FAIR-HF trial. Eur J Heart Fail. 2013;15(11):1267–76.
45. Stugiewicz M, Tkaczyszyn M, Kasztura M, Banasiak W, Ponikowski P, Jankowska EA. The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications. Eur J Heart Fail. 2016 Ene 21. doi: 10.1002/ejhf.467.
46. Haas JD, Brownlie T IV. Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship. J Nutr. 2001 Feb;131(2S-2):676S–88S.
47. Enjuanes C, Bruguera J, Grau M, Cladellas M, González G, Meroño O, et al. Estado del hierro en la insuficiencia cardiaca crónica: impacto en síntomas, clase funcional y capacidad de ejercicio submáxima. Rev Esp Cardiol. 2016;69(3):247–55.
48. Enjuanes C, Klip IT, Bruguera J, Cladellas M, Ponikowski P, Banasiak W, et al. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study. Int J Cardiol. 2014;174(2):268–75.
49. Rocca HP, Crijns HJ. Iron i.v. in heart failure: ready for implementation? Eur Heart J. 2015;36(11):645–7.
50. Ebner N, von Haehling S. Iron deficiency in heart failure: a practical guide. Nutrients. 2013;5(9):3730–9.
51. McDonagh T, Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral? Eur J Heart Fail. 2015;17(3):248–62.
52. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387:907–16.
53. Morhaim D, Auerbach M. Iron-deficiency anaemia in the Emergency Room: a new opportunity for the use of intravenous iron. Blood Transfus. 2016;14(2):91–2.
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