Management of iron deficiency in chronic heart failure: Practical considerations for clinical use and future directions

Heart Failure (HF) is a global pandemic with rapidly increasing prevalence. In an attempt to maintain patients well being, the therapeutic interest has expanded to the vicious cycles that confer to HF mortality and morbidity and a number of comorbidities have been targeted. Iron deficiency represents a common comorbid condition that affects outcomes in HF. The treatment of iron deficiency is strongly supported by the cardiologic societies all over the world. Intravenous iron, primarily ferric carboxymaltose, has shown clinical benefit in this setting, irrespective of the anemia status. Practical recommendations though are lacking. In this document, we have tried to cover the practical gap and provide useful details for intravenous iron use. •The pathophysiology of iron deficiency in heart failure is summarized.•The major randomized trials of iron replenishment in heart failure are summarized.•A proposed algorithm of screening and managing iron deficiency in heart failure patients is proposed.