Portsmouth NHS led study shows iron infusion could cut heart failure hospital admissions

Nearly one million people in the UK are living with heart failure, where the organ struggles to pump blood around the body properly. Patients can face long stays in hospital if their symptoms worsen.

Up to half of those with heart failure have low iron levels, linked to worsened symptoms, a lower quality of life and greater risk of hospitalisation and death, according to the British Heart Foundation (BHF).

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In the BHF funded study, 1,137 people with heart failure and low iron levels received either intravenous iron infusions or their usual care. Researchers found iron infusions reduced the risk of hospitalisation due to heart failure, and dying from a heart related cause, by 18 per cent compared to usual care.

People who received iron infusions also reported a better quality of life at four months. Professor Paul Kalra, honorary clinical senior lecturer at the University of Glasgow and consultant cardiologist at Portsmouth Hospitals University NHS Trust, led the study.

He said: ‘The Ironman trial shows for the first time the longer-term benefits and safety of intravenous iron treatment in heart failure, adding to the growing evidence of its favourable effects.

‘We should now be recommending that, in people with heart failure, regular assessment of iron status is performed, and treatment given if iron deficiency is found. Now is an opportune time to update national clinical guidelines.

‘Despite great advances in treatment and care in recent decades, many people with heart failure still have symptoms that impact their daily lives and rates of hospital admissions remain high.

‘We’ve shown that as little as one 60-minute treatment, repeated when needed, can be enough for most people with heart failure to top up their iron levels, help improve their wellbeing and keep them out of hospital.

‘Treatment with intravenous iron can make a real difference to patients, and this is on top of our other treatments.’

BHF said around one in 10 people will die during a heart failure hospital admission in the UK. The study looked at data from August 2016 to October 2021. Participants visited hospital every four months and had their iron levels measured.

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People in the iron group were given an infusion through an intravenous drip if their levels were low. Patients in the study, published in the Lancet, were followed up for an average of 2.7 years.

Most in the iron group, 78 per cent, received one or two intravenous iron infusions during this time. The Covid-19 pandemic impacted the study, affecting people’s willingness to visit hospitals. As a result, researchers also looked at the data from the 1,063 people who were part of the trial before March 31, 2020 and whose treatment would not have been as affected by the pandemic.

Analysis showed a stronger benefit for iron infusions over usual care, with the risk of hospitalisation due to heart failure and dying of a heart related cause 24 per cent lower in the iron group.