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Nat Rev Cardiol. 2015 Nov;12(11):659-69. doi: 10.1038/nrcardio.2015.109. Epub 2015 Jul 21.

Iron deficiency and cardiovascular disease.

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Institute of Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Göttingen Medical School, Robert-Koch-Strasse 40, 37075 Göttingen, Germany.
Department of Heart Diseases, Wroclaw Medical University, ulica Weigla 5, 50-981 Wroclaw, Poland.
Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Gronigen, Netherlands.


Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations.

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