{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:01:54Z","timestamp":1760148114101,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CSL Vifor through an unconditional grant to the Hospital Universitari i Polit\u00e8cnic La Fe de Valencia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: This study aims to analyse whether in acute heart failure (AHF) with iron deficiency (ID), the administration of ferric carboxymaltose (FCM) produces a greater benefit in renal dysfunction. Methods: A total of 812 consecutive patients admitted for AHF and ID were studied. Untreated (n:272) and treated (n:540) patients were compared. The six-month prevalence of a combined event (readmission for HF, all-cause death, and emergency department visit for decompensation) was analysed. Three grades of renal dysfunction (KDIGO) were compared, Group 1 (grades 1 and 2), Group 2 (grades 3a and 3b), and Group 3 (grades 4 and 5). Results: There were differences in sex distribution (untreated group: males 39.7% vs. treated group: males 51.9%; p &lt; 0.001). Sex-adjusted combined event analysis showed a greater benefit in Group 1 (OR: 0.31, 95% CI:0.19\u20130.5; p &lt; 0.001) and Group 2 (OR: 0.23, 95% CI:0.14\u20130.38; p &lt; 0.001), but not in Group 3 (OR: 0.51, 95% CI:0.17\u20130.55; p: 0.237). Conclusions: The administration of FCM in patients with AHF and ID reduces the combined event analysed. The benefit is greater when renal dysfunction is present, except in very advanced degrees where no significant benefit is obtained.<\/jats:p>","DOI":"10.3390\/life13040915","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T03:02:01Z","timestamp":1680231721000},"page":"915","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is the Benefit of Treating Iron Deficiency Greater in Acute Heart Failure with Renal Dysfunction?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9696-2313","authenticated-orcid":false,"given":"Raquel","family":"L\u00f3pez-Vilella","sequence":"first","affiliation":[{"name":"Heart Failure and Transplantation Unit, Hospital Universitari i Polit\u00e8cnic La Fe,106, 46026 Valencia, Spain"},{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3359-8857","authenticated-orcid":false,"given":"Borja","family":"Guerrero Cervera","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edctor","family":"Donoso Trenado","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplantation Unit, Hospital Universitari i Polit\u00e8cnic La Fe,106, 46026 Valencia, Spain"},{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"S\u00e1nchez-L\u00e1zaro","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplantation Unit, Hospital Universitari i Polit\u00e8cnic La Fe,106, 46026 Valencia, Spain"},{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-8191","authenticated-orcid":false,"given":"Luis","family":"Mart\u00ednez Dolz","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-361X","authenticated-orcid":false,"given":"Luis","family":"Almenar Bonet","sequence":"additional","affiliation":[{"name":"Heart Failure and Transplantation Unit, Hospital Universitari i Polit\u00e8cnic La Fe,106, 46026 Valencia, Spain"},{"name":"Cardiology Department, Hospital Universitari i Polit\u00e8cnic La Fe, 106, 46026 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"709872","DOI":"10.3389\/fcvm.2021.709872","article-title":"Iron Deficiency: A New Target for Patients With Heart Failure","volume":"8","author":"Rizzo","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_2","first-page":"36","article-title":"Prevalence and clinical impact of iron deficiency and anaemia among outpatients with chronic heart failure: The PrEP registry","volume":"106","author":"Gremmler","year":"2017","journal-title":"Clin. Res. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00392-018-1344-x","article-title":"Iron deficiency in patients with heart failure with preserved ejection fraction and its association with reduced exercise capacity, muscle strength and quality of life","volume":"108","author":"Bekfani","year":"2019","journal-title":"Clin. Res. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4497","DOI":"10.1002\/ehf2.13661","article-title":"Clinical characteristics of people with heart failure in Australian general practice: Results from a retrospective cohort study","volume":"8","author":"Sindone","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jacc.2021.11.039","article-title":"Criteria for Iron Deficiency in Patients With Heart Failure","volume":"79","author":"Masini","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1002\/ehf2.13245","article-title":"Diagnosis and Treatment of Iron Deficiency in Heart Failure: OFICSel study by the French Heart Failure Working Group","volume":"8","author":"Pezel","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1002\/ejhf.2338","article-title":"Phenotyping heart failure patients for iron deficiency and use of intravenous iron therapy: Data from the Swedish heart failure registry","volume":"23","author":"Becher","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/eurheartj\/ehac569","article-title":"Iron deficiency and cardiovascular disease","volume":"44","author":"Savarese","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e014254","DOI":"10.1161\/JAHA.119.014254","article-title":"Noninvasive Imaging Estimation of Myocardial Iron Repletion Following Administration of Intravenous Iron: The Myocardial-IRON Trial","volume":"9","author":"Cardells","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4222","DOI":"10.1002\/ehf2.13053","article-title":"Short-term changes in left and right systolic function following ferric carboxymaltose: A substudy of the Myocardial-IRON trial","volume":"7","author":"Santas","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1002\/ehf2.13753","article-title":"Impact of intravenous ferric carboxymaltose on heart failure with preserved and reduced ejection fraction","volume":"9","author":"Ezzitouny","year":"2022","journal-title":"ESC Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Vilella, R., Trenado, V.D., Pastor, P.J., S\u00e1nchez-L\u00e1zaro, I., Dolz, L.M., and Bonet, L.A. (2022). Why Iron Deficiency in Acute Heart Failure Should Be Treated: A Real-World Clinical Practice Study. Life, 12.","DOI":"10.3390\/life12111828"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1161\/CIRCULATIONAHA.105.577577","article-title":"Hemoglobin Level, Chronic Kidney Disease, and the Risks of Death and Hospitalization in Adults With Chronic Heart Failure: The Anemia in Chronic Heart Failure: Outcomes and Resource Utilization (ANCHOR) Study","volume":"113","author":"Go","year":"2006","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1016\/j.jacc.2006.08.034","article-title":"Etiology of Anemia in Patients With Advanced Heart Failure","volume":"48","author":"Nanas","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","first-page":"21","article-title":"Tratamiento de la anemia en el s\u00edndrome cardiorrenal","volume":"12","author":"Almenar","year":"2012","journal-title":"Rev. Esp. Cardiol. Supl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3616","DOI":"10.1093\/eurheartj\/ehz680","article-title":"Iron deficiency in worsening heart failure is associated with reduced estimated protein intake, fluid retention, inflammation, and antiplatelet use","volume":"40","author":"Dickstein","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s13670-021-00370-w","article-title":"Iron Deficiency in Heart Failure: Characteristics and Treatment","volume":"10","author":"Martin","year":"2021","journal-title":"Curr. Geriatr. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jacc.2017.12.027","article-title":"The Burden of Iron Deficiency in Heart Failure: Therapeutic Approach","volume":"71","author":"Rocha","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(20)32339-4","article-title":"Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: A multicentre, double-blind, randomised, controlled trial","volume":"396","author":"Ponikowski","year":"2020","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/eurheartj\/ehu385","article-title":"Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency","volume":"36","author":"Ponikowski","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/00015385.2017.1351239","article-title":"Impact of iron deficiency on exercise capacity and outcome in heart failure with reduced, mid-range and preserved ejection fraction","volume":"73","author":"Martens","year":"2018","journal-title":"Acta Cardiol."},{"key":"ref_23","unstructured":"L\u00f3pez-Vilella, R., Jover Pastor, P., Donoso Trenado, V., S\u00e1nchez-L\u00e1zaro, I.J., Mart\u00ednez Dolz, L., and Almenar Bonet, L. Congestion phenotypes according to diuretic combination in acute heart failure, Hellenic J. Cardiol., submitted."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.ajem.2013.12.005","article-title":"Hemodynamic profiles of ED patients with acute decompensated heart failure and their association with treatment","volume":"32","author":"Singer","year":"2014","journal-title":"Am. J. Emerg. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1053\/ajkd.2001.27699","article-title":"Anemia: An early complication of chronic renal insufficiency","volume":"38","author":"Kazmi","year":"2001","journal-title":"Am. J. Kidney Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1002\/ejhf.513","article-title":"Iron deficiency and risk of early readmission following a hospitalization for acute heart failure","volume":"18","author":"Santas","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_27","first-page":"60","article-title":"Peripheral access ultrafiltration as a treatment for cardiorenal syndrome with inadequate diuretic response","volume":"76","author":"Cervera","year":"2023","journal-title":"Initial. Exp. Rev. Esp. Cardiol. (Engl. Ed.)"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1056\/NEJMoa052256","article-title":"Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction","volume":"355","author":"Owan","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/j.kint.2021.03.020","article-title":"Controversies in optimal anemia management: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference","volume":"99","author":"Babitt","year":"2021","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1002\/ejhf.473","article-title":"Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: A meta-analysis of ran-domized controlled trials","volume":"18","author":"Jankowska","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Nemeth, E., and Ganz, T. (2021). Hepcidin-Ferroportin Interaction Controls Systemic Iron Homeostasis. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22126493"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1097\/HJH.0b013e3283434784","article-title":"Impaired expression of duodenal iron transporters in Dahl salt-sensitive heart failure rats","volume":"29","author":"Naito","year":"2011","journal-title":"J. Hypertens."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1002\/ejhf.1482","article-title":"The clinical significance of interleukin-6 in heart failure: Results from the BIOSTAT-CHF study","volume":"21","author":"Tromp","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1002\/ehf2.13265","article-title":"Iron deficiency in heart failure","volume":"8","author":"Loncar","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1056\/NEJMoa0905561","article-title":"RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation","volume":"361","author":"Connolly","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group (2012). KDIGO Clinical Practice Guideline for Anemia in, Chronic Kidney Disease. Chapter 2: Use of iron to treat anemiain CKD. Kidney Int. Suppl., 2, 292\u2013298.","DOI":"10.1038\/kisup.2012.34"},{"key":"ref_37","first-page":"71","article-title":"Perfiles anal\u00edticos pre-configurados en insuficiencia cardiaca: Implementaci\u00f3n y uso en el Sistema Nacional de Salud Espa\u00f1ol","volume":"3","year":"2022","journal-title":"Adv. Lab. Med."},{"key":"ref_38","unstructured":"Almenar Bonet, L., Blasco Peir\u00f3, M.T., Laiz Marro, B., Camafort Babkowski, M., Bu\u00f1o Soto, A., Casado Cerrada, J., and Crespo-Leiro, M.G. (2022). Preconfigured analytical profiles (PAPs) for the clinical management of the patient with Heart Failure: A consensus-driven study. Cardio Clinics, accepted."},{"key":"ref_39","unstructured":"S\u00e1nchez-L\u00e1zaro, I., Soldevila, A., L\u00f3pez-Vilella, R., Donoso, V., Devesa, R., S\u00e1nchez, P., and Almenar Bonet, L. (2023). Planificaci\u00f3n Estrat\u00e9gica de la Unidad Cardiorrenal Avanzada del Hospital Universitari i Polit\u00e8cnic La Fe, Cuquerella Medical Communications. ISBN pending, in press."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/4\/915\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:07:51Z","timestamp":1760123271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/4\/915"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["life13040915"],"URL":"https:\/\/doi.org\/10.3390\/life13040915","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2023,3,31]]}}}