Pharmacy Clinical Pearl of the Day: Iron Deficiency, Anemia in Heart Failure Patients

Heart failure outcomes improve with optimal iron levels.

Clinical Pearl of the Day:

  • Patients with heart failure patients must be evaluated and treated for Iron deficiency and anemia.
  • Prevalence over 50% in ambulatory patients.
  • Iron deficiency in heart failure is defined as: ferritin < 100 µg/L or ferritin of 100-299 µg/L with a transferrin saturation <20%.


Iron deficiency:

  • Should be screened and treated for patients with heart failure.
  • Heart failure outcomes improve as iron levels improve.
  • Intravenous iron replacement is needed because oral iron replacement trials do not show benefits.
  • Risk factors for iron deficiency include female sex, advanced heart failure, higher levels of NTpro BNP and C reactive protein.