Safety and Effectiveness of Intravenous Iron Therapy in Patients Supported by Durable Left Ventricular Assist Devices

Carli J. Peters, Thomas C. Hanff, Michael V. Genuardi, Robert Zhang, Christopher Domenico, Pavan Atluri, Jeremy A. Mazurek, Kim Urgo, Joyce Wald, Monique S. Tanna, Supriya Shore, Michael A. Acker, Lee R. Goldberg, Kenneth B. Margulies, Edo Y. Birati

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Aims: While it is common practice to use intravenous (IV) iron in patients with left ventricular assist devices (LVADs) and iron deficiency, there is insufficient evidence regarding outcomes in this patient population. We evaluated the safety and effectiveness of IV iron therapy in patients supported by LVADs with iron deficiency. Methods: We performed a retrospective analysis of iron deficient patients on continuous LVAD support at a large academic center between 2008 and 2019. Patients were divided into two cohorts based on IV iron sucrose treatment. The primary endpoint was hemoglobin at 12 weeks. Secondary endpoints were mean corpuscular volume (MCV) and New York Heart Association (NYHA) class at 12 weeks. Safety endpoints included hospitalization, infection, pump thrombosis, arrhythmia, and gastrointestinal bleed. Models were weighted by the inverse probability of receiving IV iron using a propensity score, and endpoints were adjusted for their corresponding baseline values. Results: Among 213 patients, 70 patients received IV iron and 143 patients did not. Hemoglobin at 12 weeks was significantly greater among those treated (intergroup difference: 0.6 g/dL; 95% CI, 0.1 to 1.1; p = 0.01), while MCV was similar in both groups (intergroup difference: 0.7 µm3; 95% CI, −1.3 to 2.7; p = 0.50). NYHA class distribution at 12 weeks was significantly different (odds ratio for improvement: 2.84; 95% CI, 1.42 to 4.68; p = 0.003). The hazards of adverse events in each group were similar. Conclusions: In patients with LVADs and iron deficiency, treatment with IV iron sucrose was safe and associated with improvements in functional status and hemoglobin.

Original languageEnglish
Article number3900
JournalJournal of Clinical Medicine
Volume11
Issue number13
DOIs
StatePublished - 4 Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: T.C.H. is supported by the National Institute of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) T32 Training Grant HL-007891.

FundersFunder number
National Institutes of Health
National Heart, Lung, and Blood InstituteHL-007891

    Keywords

    • intravenous iron
    • iron deficiency
    • left ventricular assist devices

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