Role of ferric carboxymaltose supplementation on comprehensive geriatric assessment in elderly patients with chronic heart failure
G Armentaro, C A Pastura, G Severini, A Panza, M R Scarcelli, V Condoleo, R Maio, A SciacquaAbstract
Background
Anaemia and iron deficiency (ID) are extremely common comorbidities in patients with chronic heart failure (CHF), particularly in the elderly, and are associated with worsening symptoms, reduced functional capacity, increased hospitalizations and increased mortality.
Purpose
The objective of this study was to evaluate the potential effect of one year therapy with SGLT2i on improving functional abilities defined as improvement of Short physical performance (SPPB) >8 pt, in a cohort of elderly patients with HFrEF/HFmrEF, ID anaemia and several comorbidities undergoing intravenous infusion of ferric carboxymaltose (FCM).
Methods
This study enrolled 222 patients, 121 men and 101 women, of Caucasian ethnicity, with a mean age of 75.5±11.0 years. The total population was stratified into two groups according to SGLT2i use: 53 with SGLT2i and 169 without SGLT2i. The primary endpoint was an achievement of SPPB ≥8 pt at one year of follow-up. A logistic regression model was performed on the primary endpoint; and the odds ratio (OR) with 95% confidence interval (95% CI) was calculated for each variable.
Results
In elderly patients with CHF and ID anaemia undergoing intravenous administration of FCM, after 1 year of follow-up, a significant improvement in the main clinical, laboratory, echocardiographic and CGA parameters were observed; however, these improvements were statistically greater in the SGLT2i group than in the other group. In addition, therapy with SGLT2i was associated with a greater probability of improvement in functional abilities by 11-fold (OR:11.05, CI 95% 4.794-25.509; p<0.0001), such as improvement in Minnesota living with HF questionnaire score (OR:1.085; CI 95% 1.003-1.174, p=0.041), while the presence of obesity was associated with a reduced probability of functional abilities improvement of 68% (OR 0.329, CI 95% 0.145-0.745, p=0.008).
Conclusions
FCM was effective in improving clinical symptoms of ID anaemia and maintaining physical function at one-year follow-up, as demonstrated by the SPPB score. These results were more pronounced in patients treated with SGLT2i.