Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy

Aims: Iron deficiency worsens symptoms, quality of life, and exercise capacity in chronic heart failure (CHF) and might do so by promoting fluid retention. We assessed whether iron repletion improved congestion in CHF and appraised the prognostic utility of calculated plasma volume status (PVS), a n...

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Authors: Okonko, Darlington O., Jouhra, Fadi, Abu-Own, Huda, Filippatos, Gerasimos, Comín Colet, Josep, Suki, Chainey, Mori, Claudio, Ponikowski, Piotr, Anker, Stefan D., FAIR-HF Investigators
Format: article
Status:Published version
Publication Date:2019
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/43177
Online Access:http://hdl.handle.net/10230/43177
http://dx.doi.org/10.1002/ehf2.12462
Access Level:Open access
Keyword:Congestion
Iron
Oedema
Plasma volume
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spelling Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudyOkonko, Darlington O.Jouhra, FadiAbu-Own, HudaFilippatos, GerasimosComín Colet, JosepSuki, ChaineyMori, ClaudioPonikowski, PiotrAnker, Stefan D.FAIR-HF InvestigatorsCongestionIronOedemaPlasma volumeAims: Iron deficiency worsens symptoms, quality of life, and exercise capacity in chronic heart failure (CHF) and might do so by promoting fluid retention. We assessed whether iron repletion improved congestion in CHF and appraised the prognostic utility of calculated plasma volume status (PVS), a novel index of congestion, in the FAIR-HF data set. Methods and results: In FAIR-HF, 459 iron deficient CHF patients were randomized to intravenous ferric carboxymaltose (FCM) or saline and assessed at 4, 12, and 24 weeks. Using weight and haematocrit, we calculated PVS in 436 patients. At baseline, PVS and weight were -5.5 ± 7.7% and 76.9 ± 14.3 kg, with peripheral oedema evident in 35% of subjects. Higher PVS values correlated to other congestion surrogates such as lower serum albumin. At 4 weeks, FCM was associated with greater reductions in weight (0.02) and PVS (P < 0.0001), and a trend for improved peripheral oedema at 24 weeks (0.07). Irrespective of treatment allocation, patients with a decrease in PVS from baseline to week 24 had higher increments in 6 min walking distance (61.4 m vs. 43.5 m, 0.02) and were more likely to improve their NYHA class (33.3% vs. 15.5%, 0.001). A PVS > -4% at baseline predicted worse outcomes even after adjustment for treatment assignment (hazard ratio 1.88, 95% confidence interval 1.01-3.51, 0.046). Conclusions: Intravenous iron therapy with FCM is associated with early reductions in PVS and weight, implying that decongestion might be one mechanism via which iron repletion aids CHF patients. Calculated PVS is of prognostic utility in this cohort.Wiley201920192019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/43177http://dx.doi.org/10.1002/ehf2.12462reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésCopyright © 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/431772026-05-29T05:05:01Z
dc.title.none.fl_str_mv Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
title Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
spellingShingle Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
Okonko, Darlington O.
Congestion
Iron
Oedema
Plasma volume
title_short Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
title_full Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
title_fullStr Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
title_full_unstemmed Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
title_sort Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy
dc.creator.none.fl_str_mv Okonko, Darlington O.
Jouhra, Fadi
Abu-Own, Huda
Filippatos, Gerasimos
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
FAIR-HF Investigators
author Okonko, Darlington O.
author_facet Okonko, Darlington O.
Jouhra, Fadi
Abu-Own, Huda
Filippatos, Gerasimos
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
FAIR-HF Investigators
author_role author
author2 Jouhra, Fadi
Abu-Own, Huda
Filippatos, Gerasimos
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
FAIR-HF Investigators
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Congestion
Iron
Oedema
Plasma volume
topic Congestion
Iron
Oedema
Plasma volume
description Aims: Iron deficiency worsens symptoms, quality of life, and exercise capacity in chronic heart failure (CHF) and might do so by promoting fluid retention. We assessed whether iron repletion improved congestion in CHF and appraised the prognostic utility of calculated plasma volume status (PVS), a novel index of congestion, in the FAIR-HF data set. Methods and results: In FAIR-HF, 459 iron deficient CHF patients were randomized to intravenous ferric carboxymaltose (FCM) or saline and assessed at 4, 12, and 24 weeks. Using weight and haematocrit, we calculated PVS in 436 patients. At baseline, PVS and weight were -5.5 ± 7.7% and 76.9 ± 14.3 kg, with peripheral oedema evident in 35% of subjects. Higher PVS values correlated to other congestion surrogates such as lower serum albumin. At 4 weeks, FCM was associated with greater reductions in weight (0.02) and PVS (P < 0.0001), and a trend for improved peripheral oedema at 24 weeks (0.07). Irrespective of treatment allocation, patients with a decrease in PVS from baseline to week 24 had higher increments in 6 min walking distance (61.4 m vs. 43.5 m, 0.02) and were more likely to improve their NYHA class (33.3% vs. 15.5%, 0.001). A PVS > -4% at baseline predicted worse outcomes even after adjustment for treatment assignment (hazard ratio 1.88, 95% confidence interval 1.01-3.51, 0.046). Conclusions: Intravenous iron therapy with FCM is associated with early reductions in PVS and weight, implying that decongestion might be one mechanism via which iron repletion aids CHF patients. Calculated PVS is of prognostic utility in this cohort.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/43177
http://dx.doi.org/10.1002/ehf2.12462
url http://hdl.handle.net/10230/43177
http://dx.doi.org/10.1002/ehf2.12462
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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