OBJECTIVES

Randomized placebo-controlled trials with Ferric Carboxymaltose (FCM) have shown a clinical benefit in the correction of iron deficiency (ID) in patients with Chronic Heart Failure (CHF). FCM is associated with significant improvements in functional capacity, symptoms and quality of life. Reduction in the risk of first hospitalization and recurrent hospitalization due to worsening heart failure were also identified. The aim of this study is to investigate if FCM therapy could be associated with a reduction of recurrent hospital admissions and ambulatory visits in routine clinical practice. A hospital registry in the Spanish NHS is used to analyze retrospectively data from 1,498 CHF patients.

METHODS

The hospital registry provides information of 1,498 patients (10,522 observations) from 2010 to 2019 with an average follow-up period of 4.02 years. The registry allows the extraction and analysis of data related to demographic and clinical characteristics, laboratory tests and healthcare resource use of two cohorts of CHF patients with ID: 317 patients who received intravenous iron-replacement therapy with FCM and 1,181 patients who did not receive FCM. The statistical method used was multilevel negative binomial regression with random intercept on patient ID and time follow-up as offset.

RESULTS

The incidence rate of iron deficiency in the whole sample was 0.488 events per person-year. Treatment with FCM was strongly associated with a decrease in the rate of recurrent hospitalizations (IRR = 0.25, 95% CI 0.15-0.44; P <0.001), even after controlling for age, gender, diabetes, HF-ethiology, ferritin and TSAT. In addition, and compared to patients who received FCM, those with no treatment with FCM showed higher risk of ambulatory visits (IRR = 2.08, 95% CI 1.90-2.27; P <0.001)

CONCLUSIONS

This study shows that intravenous FCM is associated with a reduction in recurrent hospitalizations and ambulatory visits for patients with iron deficiency and CHF in routine clinical practice.