Heart failure

Could Oral Iron Supplementation Improve Exercise Capacity in HF Patients?

Oral iron supplements did not improve exercise capacity in older patients with heart failure and iron deficiency, according to the findings of a recent study.

The double-blind, placebo-controlled, randomized clinical trial included 225 patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and iron deficiency (36% of participants were women, median age 63 years). For 16 weeks, 111 patients took 150 mg oral iron polysaccaharide twice a day, and 114 participants took a matched placebo.
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Changes in peak oxygen uptake (VO2) from baseline to 16 weeks was assessed as the primary end point, and changes in 6-minute walk distance, plasma N-terminal pro-B-type natriuretic peptide (NY-proBNP) levels, and Kanas City Cardiomyopathy Questionnaire (KCCQ) scores were assessed as the secondary end points.

A total of 203 participants completed the study. The median baseline peak VO2 of participants in the oral iron group was 1196 mL/min and the median baseline peak VO2 of participants in the placebo group was 1157 mL/min.

At week 16, the researchers did not observe any significant changes in peak VO2 between the groups, and there were no significant differences in the 6-minute walk distance, NT-proBNP levels, or KCCQ scores.

“Among participants with HFrEF with iron deficiency, high-dose oral iron did not improve exercise capacity over 16 weeks,” the researchers concluded. “These results do not support use of oral iron supplementation in patients with HFrEF.”

—Melissa Weiss

Reference:

Lewis GD, Malhotra R, Hernandez AD, et al. Effect of oral iron repletion on exercise capacity in patients with heart failure with reduced ejection fraction and iron deficiency: the IRONOUT HF randomized clinical trial [published online March 16, 2017]. JAMA. doi:10.1001/jama.2017.5427.