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

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 i...

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Autores: Okonko, Darlington O., Jouhra, Fadi, Abu‐Own, Huda, Filippatos, Gerasimos S., Comín Colet, Josep, Suki, Chainey, Mori, Claudio, Ponikowski, Piotr, Anker, Stefan D.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/189282
Acceso en línea:https://hdl.handle.net/2445/189282
Access Level:acceso abierto
Palabra clave:Dèficit de ferro
Insuficiència cardíaca
Plasma sanguini
Iron deficiency diseases
Heart failure
Blood plasma
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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, Gerasimos S.Comín Colet, JosepSuki, ChaineyMori, ClaudioPonikowski, PiotrAnker, Stefan D.Dèficit de ferroInsuficiència cardíacaPlasma sanguiniIron deficiency diseasesHeart failureBlood plasmaIron 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.John Wiley & Sons2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/189282Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1002/ehf2.12462ESC Heart Failure, 2019, vol. 6, num. 4, p. 621-628https://doi.org/10.1002/ehf2.12462cc-by-nc-nd (c) Okonko, Darlington O. et al., 2019https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1892822026-05-27T06:46:51Z
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.
Dèficit de ferro
Insuficiència cardíaca
Plasma sanguini
Iron deficiency diseases
Heart failure
Blood plasma
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 S.
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
author Okonko, Darlington O.
author_facet Okonko, Darlington O.
Jouhra, Fadi
Abu‐Own, Huda
Filippatos, Gerasimos S.
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
author_role author
author2 Jouhra, Fadi
Abu‐Own, Huda
Filippatos, Gerasimos S.
Comín Colet, Josep
Suki, Chainey
Mori, Claudio
Ponikowski, Piotr
Anker, Stefan D.
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Dèficit de ferro
Insuficiència cardíaca
Plasma sanguini
Iron deficiency diseases
Heart failure
Blood plasma
topic Dèficit de ferro
Insuficiència cardíaca
Plasma sanguini
Iron deficiency diseases
Heart failure
Blood plasma
description 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
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 https://hdl.handle.net/2445/189282
url https://hdl.handle.net/2445/189282
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1002/ehf2.12462
ESC Heart Failure, 2019, vol. 6, num. 4, p. 621-628
https://doi.org/10.1002/ehf2.12462
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Okonko, Darlington O. et al., 2019
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Okonko, Darlington O. et al., 2019
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv John Wiley & Sons
publisher.none.fl_str_mv John Wiley & Sons
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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