scholarly journals Prevalence and spectrum of iron deficiency anaemia in heart failure patients

2019 ◽  
Vol 7 (1) ◽  
pp. 132
Author(s):  
Gaurav Mohan ◽  
Gurinder Mohan ◽  
Manish Chandey ◽  
Avneet Kaur ◽  
Trimaan Singh Sikand ◽  
...  

Background: To study the prevalence and pattern of iron deficiency (ID)in heart failure (HF) patients with or without anaemia.Methods: This is a single-centre observational study, conducted at a tertiary care hospital of Punjab. Patients were selected based on validated clinical criteria-Framingham criteria. The iron parameters were done during the study including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT), to diagnose iron deficiency anaemia. Anaemia was defined as haemoglobin (Hb) < 13g/dl in males and <12 g/dL in females, based on WHO definition. Absolute iron deficiency is defined as serum ferritin < 100 mg/L and functional ID was defined as normal serum ferritin (100–300 mg/L) with low TSAT (<20%).Results: A total of 120 patients of Heart Failure (54% males and 46% females) were studied. Most of the patients were of high-functional NYHA class (Class IV NYHA n=45). Iron Deficiency was present in 60% patients with 31.66% patients having absolute and 28.33% patients having functional ID. Nearly one-fifth of the patients were having ID but without anemia, signifying importance of workup of Iron deficiency other than haemoglobin levels.Conclusions: Study highlights the neglected burden of ID in HF patients in India. This study suggests further large-scale studies to better characterize this easily treatable condition and considering routine testing in future Indian guidelines.

Author(s):  
Kulbhushan Badyal ◽  
Shivani Panhotra

Background: Data on the burden of Iron deficiency (ID) in Heart failure (HF) patients in India are sparse and there is very little information available about the prevalence of iron deficiency in heart failure with mid-range (HFmrEF) and preserved ejection fraction (HFpEF) in comparison to heart failure with reduced ejection-fraction (HFrEF). Aims and Objective: This study was carried out with aim to evaluate iron profile in HF patients and to know the prevalence of ID in HFpEF, HFmrEF and HFrEF in our region. Materials and Methods: Patients with clinically diagnosed HF were enrolled in the study. This was a single tertiary care centre, prospective, observational study carried out from December 2017 to November 2018. Patients were classified into HFrEF, HFmrEF and HFpEF on echocardiography. Serum ferritin (micrograms per liter), serum iron (micrograms per liter), total iron binding capacity (micrograms per liter), transferrin (milligrams per deciliter), and transferrin saturation were measured to assess iron status. Absolute ID was defined as serum ferritin < 100 mg/L and functional ID was defined as normal serum ferritin (100–300 mg/L) with low TSAT (<20%). Results: A total of 120 patients of HF (66.7% males and 33.3% females) were studied. Out of 120 patients, 78 (65%) patients of HF had ID. Absolute ID was in 38.3% and functional ID was seen in 26.7% patients. 62.5% of males had ID, whereas, 70% of females had ID in HF. Patients with ID had higher NYHA Class, 35.9% compared to 23.8% patients without ID. ID was high in all subsets of HF. ID was found in 61.11% in HFrEF, 67.44% in HFmrEF and 69.57% in HFpEF. P-0.71. 14.1% patients had ID, but no anemia (p- 0.02). In anemic patients, ID was more (85.2%) than non anemic patients (69%). Conclusion: In our study, prevalence of ID was higher in patients of HF than that reported from western literature. HFpEF had higher prevalence of ID followed by HFmrEF and HFrEF, respectively. Literature is scanty about HFmrEF, our study has given an insight of ID in this subset of HF. ID can occur even without anemia and females are more prone to have ID in HF. Our study highlights the importance of diagnosis and treatment of ID in all subsets of HF, in order to improve quality of life, morbidity and mortality in patients of HF. Keywords: Iron deficiency, Heart Failure, Anemia, HFrEF, HFmrEF, HFpEF


2021 ◽  
Vol 8 (22) ◽  
pp. 1803-1807
Author(s):  
Anish Kumar Vishal ◽  
Dinesh Bhasin ◽  
Vidhu Dhar Dangwal ◽  
Anurakshat Bhasin

BACKGROUND Anaemia is one of the major public health problems in developing nations. Iron deficiency anaemia (IDA) is the commonest type of anaemia in pregnancy. Parenteral iron therapy is a recommended modality of treatment of IDA. Inj. Ferric Carboxymaltose (FCM) is a dextran free preparation which is safe, easy to deliver and better tolerated. A maximum of 1000 mg can be infused at a time. The present study was intended to assess the efficacy and safety of Inj. FCM in the treatment of iron deficiency anaemia in the second and third trimester. METHODS This prospective study was conducted at a tertiary care centre at Pune. Pregnant women with iron deficiency anaemia of moderate and severe grade were infused 1000 mg of Inj. FCM by longer infusion protocol. A total of 165 pregnant women were included in the study. The efficacy of Inj. FCM was monitored by the rise in the haemoglobin level at 03-, 06- and 08-weeks post infusion of FCM injection and serum Ferritin levels. The safety was assessed by analysing the adverse reactions. RESULTS No serious adverse reaction was recorded in any of the patients. The rise in haemoglobin (Hb) in second and third trimester of moderate and severe grade of anaemia was significant (P < 0.001). The target level of 10 g / dl was achieved in every patient. Only 03 patients received blood transfusion and that was for obstetric indications. No blood transfusion was because of anaemia per se. The rise in serum ferritin level was also statistically significant (P < 0.001). CONCLUSIONS Inj. FCM is an excellent modality to treat iron deficiency anaemia in pregnancy. It is safe and the rise of haemoglobin with correction of anaemia is satisfactory in a short span of time. In our country where only a handful of patients had regular antenatal check-up and non-compliancy and refractory anaemia is rampant, Inj. FCM is a big boon. KEYWORDS Iron Deficiency Anaemia, Inj. Ferric Carboxymaltose, Serum Ferritin, Blood Transfusion


Author(s):  
Ganesh N. Dakhle ◽  
Mrunalini V. Kalikar ◽  
Rujuta P. Fuke ◽  
Anisha S. Parmarthi ◽  
Mrunalini K. Chokhandre

Background: Postpartum anaemia often leads to multiple clinical complications in mother as well as infant and iron supplementation with parenteral iron is the preferred treatment modality. The present study was planned to compare the efficacy and tolerability of IV iron sucrose and IV ferric carboxymaltose in treatment of postpartum iron deficiency anaemia.Methods: This randomized, parallel, open label, prospective 4-weeks study was conducted from June 2019 to December 2020 in women with postpartum anaemia admitted to obstetrics and gynaecology inpatient department of a tertiary care hospital. Women with postpartum iron deficiency anaemia (N=60) were randomly divided into two groups; receiving Injection iron sucrose (N=30, maximum dose 500 mg) or Injection ferric carboxymaltose (N=30, maximum dose 500 mg). Change in haemoglobin and serum ferritin levels from baseline to the end of 2 and 4 weeks of treatment were evaluated.Results: The results showed early, sustained and significant increase in the haemoglobin levels in both the groups. However, the difference was not significant between groups (p=0.2). Evaluation of replenishment of iron stores (serum ferritin) showed improvement in both the groups, however in FCM group the rise was found to be significant (p<0.05).Conclusions: FCM in a lower dose of 500mg was found to be safe and effective in significantly improving haemoglobin concentration as well as in replenishing iron stores in patients with postpartum anaemia.


2021 ◽  
Vol 19 (1) ◽  
pp. 66-70
Author(s):  
Brajesh Raj Chaudhary ◽  
Kalpana Karmacharya Malla ◽  
Binod Gaire

Background: Febrile seizure is the most common cause of seizure in children. Iron deficiency, by lowering seizure threshold, is proposed to be one of the risk factors for febrile seizure. Many studies have been done to determine the association of iron deficiency anemia with febrile seizure but the results are controversial. Hence, the present study was conducted to evaluate the association of iron deficiency anemia with febrile seizure in Nepalese children. Methods: A prospective age and sex matched case control study was performed in 68 cases of febrile seizures and 68 controls of febrile illness without seizure after calculating the sample size. The study was conducted from October 21, 2019 to October 20, 2020 in Pediatric ward and intensive care unit of College of Medical Sciences, Bharatpur, Nepal after obtaining ethical clearance from institutional review committee. Data entry was done in statistical packages for the social science version 20.Results: Mean of haematological parameters (haemoglobin and mean corpuscular volume) as well as mean of serum iron, ferritin and transferrin saturation were significantly less and total iron binding capacity was significantly high in cases as compared to controls (P <0.05). Iron deficiency anemia was significantly associated with cases (59.7%), with odds ratio of 2.5 (95% confidence interval =1.24 – 5.01) as compared to control (40.3%) (P <0.05).Conclusions: Iron deficiency anemia may be considered one of the risk factors for febrile seizure in children. Hence, Children with febrile seizure should be investigated and treated for Iron deficiency anemia.Keywords: Children; febrile seizure; iron deficiency anemia


Author(s):  
LF Mogongoa

Background: Iron deficiency anaemia is the most commonly encountered form of anaemia in females worldwide. This form of anaemia is, amongst others, associated with geophagia that is defined as the consumption of soil. The two main reasons for the association of geophagia with anaemia are that soil is thought to supplement mineral deficiency and geophagia is seen as a symptom of the anaemia. However, it is hypothesised that soil consumption interferes with iron absorption instead of supplementing it. The first line of therapy for iron deficiency anaemia is oral iron. Therefore, if soil consumption interferes with iron absorption it could interfere with oral iron therapy leading to patients being burdened with symptoms of anaemia as treatment is not effective. The aim of the study was to evaluate the efficacy of oral iron therapy in female participants afflicted with iron deficiency anaemia associated with geophagia. Methods: In this prospective randomised intervention study, 84 geophagic women with iron deficiency anaemia were divided into two groups. One group continued with soil consumption while the other stopped consumption. Oral iron therapy was administered for ten weeks at increasing therapy doses for both groups. Red cell and iron study parameters were evaluated at different time intervals to ascertain the efficacy of iron replacement therapy. Results: The group that stopped soil consumption showed a statistically significant change in haemoglobin (9.4 to 10.0 g/dL, p = 0.029), mean corpuscular volume (73.6 to 75.7 fl), mean corpuscular haemoglobin (23.7 to 24.6 pg), serum iron (22.5 to 28 μg/dL, p < 0.001, transferrin saturation (4.8 to 6.9%, p < 0.001) and total iron-binding capacity (467 to 441 μg/L, p = 0.001). These findings were contrary to the group that continued with consumption, where the statistical changes were only observed for the iron study parameters (serum iron: 21 to 28 μg/dL, p = 0.038; transferrin saturation: 4.3 to 6.9%, p = 0.011; total iron-binding capacity: 496 to 421 μg/L, p = 0.002). Nevertheless, the changes for both groups were clinically insignificant. Oral iron therapy did not correct the anaemia in geophagic females of both groups, this could be explained by two hypotheses where soil affected the gastrointestinal lining and soil directly interfered with therapy iron absorption. This is evidenced by the group that continued with consumption showing fewer changes than the group that abstained from soil consumption. These results were consistent with a case study where oral iron therapy was implemented. Conclusion: Oral iron therapy was not effective in geophagia cases of iron deficiency anaemia.


2019 ◽  
Vol 39 (3) ◽  
pp. 174-180
Author(s):  
Sneha Kaushik ◽  
Anita Yadav ◽  
Pradeep Kumar Debata ◽  
Kailash Chandra Aggarwal

Introduction: Iron deficiency anaemia is common in developing nations and starting iron supplementation from infancy is an important measure for its prevention. There is still not enough evidence, whether giving iron twice weekly as compared to daily, is enough to prevent the same. Methods: This open-labeled randomised control trial was conducted at a tertiary care facility over a period of 1.5 years. After informed consent from parents, a total of 125 non-anaemic healthy infants in age group six to 24 months; with birth weight > 2500 grams, born singleton at term gestation and predominantly breastfed in the first six months of life; were randomised using computer generated sequence to two groups. Control group received daily elemental iron supplementation of 1 mg/kg/day and the intervention group received twice weekly 2 mg/kg/day. Haemoglobin, serum ferritin were measured at enrolment and at the end of 100 days. Primary outcome was anaemia defined as haemoglobin less than 11 mg/dl. Secondary outcome measures were weight gain, increase in length and occipito-frontal circumference. Results: Baseline characteristics were similar in the two groups. This study showed significantly higher mean haemoglobin (mg/dl) (mean ± SD 11.882 ± 0.3237, 11.683 ± 0.4264, p = 0.009) and mean serum ferritin (ng/ml) (mean ± SD 101.704 ± 23.0263, 62.149 ± 24.2079, p = 0.000) at end of 100 days in the control group than the intervention group. There was no difference in any of the secondary outcomes. Conclusions: Biweekly iron supplementation can also prevent iron deficiency anaemia in children between six to 24 months of age but daily is better in respect to the increase in haemoglobin.


2018 ◽  
Vol 5 (4) ◽  
pp. 828
Author(s):  
Vishnu Anjan Nareddy ◽  
M. Sai Varun ◽  
Nagabushana M.V.

Background: Iron deficiency anaemia still remains the most common cause of anaemia not only in India but also world over. According to world heath report, there are 1,788,600 people in this world suffering from Iron deficiency anaemia. Iron deficiency anaemia is foremost prevalent disease-causing morbidity in world and therefore it is always absolutely necessary to detect this particular condition in early stages before the eventual development of various dreadful complications like Heart failure and Myocardial infarction. The aim of the study is to find incidence of iron deficiency anaemia in patients with hypo proliferative anaemia presentation, with a possible iron deficient state, by analyzing the haematological and biochemical parameters.Methods: The study was conducted from November 2017 to May 2018 for a period of 6 months which included 50 subjects from both sex groups, aged 20-80 years with the diagnosis of hypo proliferative anaemia.Results: The study results indicate that females (60%) were significantly overrepresented compared to males (40%). Of the 50 subjects 38% were in stage of negative iron balance (stage1) and 32% were in stage of iron deficient erythropoiesis(stage2) and 30% were in normal stage.Conclusions: This Observational study showed a majority of patients with hypo-proliferative anaemia presenting at early stages of negative iron balance and iron deficient erythropoiesis thereby indicating the importance of initiating iron therapy at an early stage even without correlative iron studies.


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