EFFECTS OF IRON REPLACEMENT IN IRON DEFICIENT CHRONIC HEART FAILURE PATIENTS IN SETTINGS OF GOVERNMENT SECTOR HOSPITALS OF KHYBER PAKHTUNKHWA

Introduction: Heart Failure is a common problem and major cause of morbidity, mortality and impaired quality of life. Deficiency of iron is common in heart failure patients but the optimum diagnostic tests for detection of iron deficiency and treatment options to replace iron have not been fully characterized. This study was performed to determine whether intravenous iron therapy would improve the symptoms of iron deficient chronic heart failure patients. Materials & Methods: This was a cross sectional descriptive study in which 96 patients with symptomatic cardiac failure NYHA class II and III were selected from selected tertiary care hospitals of Peshawar, KP, through convenience sampling. Serum ferritin, serum BNP, echocardiography and 6 Minutes’ Walk tests were conducted on all patients, and 38 patients with iron deficiency (Serum Ferritin<100µg/ml) were identified. Intravenous iron was administered to the iron deficient patients weekly for 6 weeks and patients were reassessed through repeat investigations to determine the efficacy of intravenous iron administration in chronic heart failure patients. Results: High compliance of patients with intravenous iron administration was observed (87%) with symptomatic, biochemical and physical evidence of improvement. After 6 weeks of treatment, reanalysis of these patients indicated significant improvements in Serum Ferritin levels (p<0.001), Serum BNP levels (p=0.002), Echocardiographic findings (p=0.013), 6 Minutes’ Walk test (p < 0.001) and NYHA class shift in 76% of patients (p<0.001). Conclusions: Parenteral iron administration is an effective modality in managing patients of NYHS class II and III cardiac failure patients. Keywords: Heart Failure, Anemia, Iron Deficiency , Brain Natriuretic Peptide, Ferritin.