Skill Checkup: A 69‐Year‐Old Woman With Acutely Worsening Heart Failure

The ESC guidelines recommend treatment with IV ferric carboxymaltose in symptomatic HF patients with iron deficiency. The US guidelines do not recommend a specific formulation.

Risk factors for iron deficiency in HF include female sex, advanced HF, and higher levels of N-terminal pro–B-type natriuretic peptide and C-reactive protein. Three main mechanisms underlie the deficiency: low iron intake, which depends on diet; decreased iron absorption, which is associated with gastrointestinal abnormalities; and increased iron loss, owing to hemorrhages or proteinuria.

Finally, the AFFIRM-AHF trial showed that IV ferric carboxymaltose treatment in patients with iron deficiency who have stabilized after an acute HF episode reduced the risk of future HF hospitalizations.

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Cite this: Marco Guazzi. Skill Checkup: A 69‐Year‐Old Woman With Acutely Worsening Heart Failure - Medscape - Mar 21, 2022.