Iron deficiency (ID) is highly prevalent in patients with heart failure (HF) and is independently associated with poorer functional status, higher hospitalization rates, and increased mortality. ID in HF is typically defined by abnormal iron indices—most commonly low ferritin and/or low transferrin saturation—and is distinct from anemia, as it may be present even when hemoglobin levels are normal. A growing body of randomized clinical trials demonstrates that treating ID, particularly with intravenous iron, improves symptoms, exercise capacity, and quality of life, with emerging evidence for reductions in HF hospitalizations.

In this interview, Clyde W. Yancy MD, MACC and Robert J. Mentz, MD, FACC examine definitions and treatment of ID in HF.

Related References:

1. Mentz RJ, Garg J, Rockhold FW, et al. Ferric Carboxymaltose in Heart Failure with Iron Deficiency. N Engl J Med. 2023;389(11):975-986. doi:10.1056/NEJMoa2304968
2. Anker SD, Friede T, Butler J, et al. Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency: The FAIR-HF2 DZHK05 Randomized Clinical Trial. JAMA. 2025;333(22):1965-1976. doi:10.1001/jama.2025.3833
3. 3. Packer M, Anker SD, Butler J, et al. Redefining Iron Deficiency in Patients With Chronic Heart Failure. Circulation. 2024;150(2):151-161. doi:10.1161/CIRCULATIONAHA.124.068883