Cardiology
In the three trials, a total of 4,501 patients with heart failure and reduced or mildly reduced left ventricular ejection fraction and iron deficiency were randomly assigned to FCM (n=2,251) or placebo (n=2,250). The mean age of the total population was 69 years, 63% were men, and the mean left ventricular ejection fraction was 32%. FCM therapy significantly reduced the co-primary composite endpoint of total cardiovascular hospitalisations and cardiovascular death compared with placebo, with a rate ratio (RR) of 0.86 (95% confidence interval [CI] 0.75 to 0.98; p=0.029). There was a trend towards reduction of the co-primary composite endpoint of total heart failure hospitalisations and cardiovascular death but it failed to reach statistical significance (RR 0.87; 95% CI 0.75 to 1.01; p=0.076). FCM therapy was associated with a 17%
relative rate reduction in total cardiovascular hospitalisations (RR 0.83; 95% CI 0.73 to 0.96; p=0.009) and a 16% relative rate reduction in total heart failure hospitalisations (RR 0.84; 95% CI 0.71 to 0.98; p=0.025). There was no effect of FCM administration on mortality. In subgroup analyses, patients in the lowest
transferrin saturation (TSAT) tertile (<15%) derived greater benefit from FCM on the composite endpoint of total cardiovascular hospitalisations or cardiovascular death than those with higher baseline TSAT (interaction p=0.019). Treatment with FCM appeared to be safe and well-tolerated. Principal investigator, Professor Piotr
Ponikowski of Wroclaw Medical University, Poland, said: “This was the largest and most up-to-date analysis of the effect of FCM in iron-deficient heart failure patients with reduced or mildly reduced ejection fraction. FCM was associated with a reduction in the composite endpoint of total cardiovascular hospitalisations and cardiovascular death compared with placebo, and with significantly reduced risks of hospitalisation due to heart failure or cardiovascular causes, with no effect on survival. “The findings indicate that intravenous FCM should be considered in iron-deficient patients with heart failure and reduced or mildly reduced ejection fraction to reduce the risk of hospitalisation due to heart failure and cardiovascular causes.”
took place on Sunday 27 August.
2. Armstrong AC, Gidding S, Gjesdal O, et al. LV mass assessed by echocardiography and CMR, cardiovascular outcomes, and medical practice.JACC Cardiovasc Imaging. 2012;5:837- 848.
3. The Children of the 90s study is also known as the Avon Longitudinal Study of Parents and Children (ALSPAC).
4. de Simone G, Kizer JR, Chinali M, et al. Normalization for body size and population- attributable risk of left ventricular hypertrophy: the Strong Heart
Study.Am J Hypertens. 2005;18(2 Pt 1):191-196.
5. FRAIL-AF was discussed during Hot Line 6 on Sunday 27 August.
6. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2020;42:373–498.
CSJ
References 1. The abstract “Cumulative accelerometer-based sedentary time from childhood through young adulthood with progressive left ventricular remodelling in British youth: a 13-year longitudinal study” was presented during the session ‘Physical inactivity and exercise’ which
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www.clinicalservicesjournal.com I March 2024
7. Savelieva I, Fumagalli S, Kenny RA, et al. EHRA expert consensus document on the management of arrhythmias in frailty syndrome, endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA).Europace. 2023;25:1249–1276.
8. Joosten LPT, van Doorn S, Hoes AW, et al. Safety of switching from vitamin K antagonist to non-vitamin K antagonist oral anticoagulant in frail elderly with atrial fibrillation: rationale and design of the FRAIL-AF randomised controlled
trial.BMJ Open. 2019;9:e032488.
9. OCT vs. IVUS vs. angiography guidance was discussed during Hot Line 4 on Sunday 27 August..
10 . Effects of FCM meta-analysis was discussed during Hot Line 2 on Saturday 26 August.
11. Rocha BML, Cunha GJL, Menezes Falcão LF. The burden of iron deficiency in heart failure: therapeutic approach.J Am Coll Cardiol. 2018;71:782-793.
12. Ponikowski P, van Veldhuisen DJ, Comin- Colet J, et al. Beneficial effects of long- term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2015;36:657-668.
13. Anker SD, Comin Colet J, Filippatos G, et al. Ferric carboxymaltose in patients with heart failure and iron deficiency.N Engl J Med. 2009;361:2436-2448.
About the ESC Congress
ESC Congress is the world’s largest gathering of cardiovascular professionals, disseminating ground-breaking science both onsite in Amsterdam and online. The event is hosted by the European Society of Cardiology, which brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives. The next ESC Congress 2024 will be held in London, UK from 30 August to 2 September 2024.
www.escardio.org
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