Cardiology and Cardiothoracic Surgery

Iron deficiency is a prevalent condition among patients with heart conditions. If overlooked, this nutritional deficiency can significantly affect cardiovascular function and compromise patients' quality of life.

The impact of Iron Deficiency in Cardiology and Cardiac Surgery

Iron is crucial for oxygen transport and the proper functioning of the heart muscle. When iron levels are low, the efficiency of the entire cardiovascular system is compromised, worsening heart failure symptoms and limiting the ability to exercise.

Correcting this deficiency is not just a therapeutic option; it is essential for improving clinical outcomes and enhancing patients' overall well-being.

Iron deficiency in patients with cardiovascular disease leads to:

Reduced functional capacity: Lower levels of haemoglobin and myoglobin restrict the oxygen supply to tissues, resulting in fatigue, shortness of breath and muscle weakness.
Worsening of heart failure symptoms: Clinical studies indicate that iron deficiency exacerbates symptoms like shortness of breath and fatigue in patients with chronic heart failure.
Compromised cardiac function: Iron deficiency impairs myocardial contractility and energy production in the heart, worsening ventricular dysfunction.
Increased risk of heart failure: clinical studies show that iron deficiency is common among patients with chronic heart failure and contributes to a poorer prognosis.
Higher incidence of post-operative complications: in cardiac surgery patients, iron deficiency can negatively impact post-operative recovery, leading to more complications.

Other relevant nutritional deficiencies in cardiology: vitamins D3 and B12

In addition to iron, deficiencies in Vitamin D3 and Vitamin B12, both crucial for cardiovascular health, are frequently observed in cardiology patients:

Vitamin D3: involved in regulating calcium metabolism and endothelial function, its deficiency is linked to an increased risk of hypertension and cardiac dysfunction.
Vitamin B12: essential for red blood cell production and homocysteine metabolism, its deficiency can lead to anaemia and elevate the risk of cardiovascular events.

Iron and vitamin supplementation: what cardiovascular research says

Assessing and correcting nutritional deficiencies, particularly iron, Vitamin D3 and Vitamin B12, is a critical part of managing cardiology patients.

Research highlights that correcting iron deficiency is especially vital for improving quality of life, enhancing the capacity to exercise, alleviating symptoms and reducing hospitalisations in heart failure patients. Moreover, early intervention for iron deficiency can lead to a better response to therapeutic treatments, reducing the need for transfusions.

A proactive approach with proper iron supplementation, ideally oral to avoid the risks of intravenous treatments, has been shown to deliver rapid and lasting clinical benefits, enhancing patients' quality of life while also improving their long-term prognosis.

Weltert, L.P.; De Rosa, A.; Rondinelli, M.B.; Falco, M.; Turani, F.; Pierelli, L. Benefits of pre-operative oral Sucrosomial® iron supplementation in cardiac surgery: Influence of patient’s baseline hemoglobin and gender. Blood Transfus. 2022. doi: 10.2450/2022.0222-22
Venturini, E.; Iannuzzo, G.; DI Lorenzo, A.; Cuomo, G.; D’Angelo, A.; Merone, P.; Cudemo, G.; Pacileo, M.; D’Andrea, A.; Vigorito,C.; et al. Short-term treatment of iron deficiency anemia after cardiac surgery. IJC Heart Vasc. 2022, https://doi.org/10.1016/j.ijcha.2022.101038.
Pierelli, L.; De Rosa, A.; Falco, M.; Papi, E.; Rondinelli, M.; Turani, F.; Weltert, L. Preoperative Sucrosomial Iron Supplementation Increases Haemoglobin and Reduces Transfusion Requirements in Elective Heart Surgery Patients: A Prospective Randomized Study. Surg. Technol. Int. 2021, 39, 321–328. DOI: 10.52198/21.STI.39.CV1512
Ghio, S.; Fortuni, F.; Capettini, A.C.; Scelsi, L.; Greco, A.; Vullo, E.; Raineri, C.; Guida, S.; Turco, A.; Gargiulo, C.; et al. Iron deficiency in pulmonary arterial hypertension: Prevalence and potential usefulness of oral supplementation. Acta Cardiol. 2021,76, 162–167. DOI: 10.1080/00015385.2019.1694760
Karavidas A, Troganis E, Lazaros G, Balta D, Karavidas IN, Polyzogopoulou E, Parissis J, Farmakis D. Oral sucrosomial iron improves exercise capacity and quality of life in heart failure with reduced ejection fraction and iron deficiency: a non-randomized, open-label, proof-of-concept study. Eur J Heart Fail. 2021 Apr;23(4):593-597. DOI: 10.1002/ejhf.2092
Testa R., Venturini E., Sansoni C., Pera E., Tarantino G. Oral Sucrosomial® Iron in Post Cardiac Surgery Patients. Efficacy and Tolerability in a Follow up of 3 Months. Expert Review of Hematology, 10(sup1), 1–40. https://doi.org/10.1080/17474086.2017.1399059
Grossi A., Baldari F, Codraro S, Pagliaroli F, G.A. Gala, La Rocca D. Sucrosomial® iron: short-term efficacy compared to administration of 4 capsules/day for 7 days vs. 2 capsules/day for 14 days in post cardiac surgery patients for myocardial revascularization. Expert Review of Hematology, 10(sup1), 1–40. https://doi.org/10.1080/17474086.2017.1399059
Marazia S., Loderini S, Magliari F, M Sarullo F.M., Di Mauro M. Sucrosomial® iron supplementation can be a useful support treatment in patients with heart failure and anemia. Expert Review of Hematology, 10(sup1), 1–40. https://doi.org/10.1080/17474086.2017.1399059
Mircoli L., Tonella T., Lombardi F. Role of anemia and iron supplementation on in-hospital and long-term prognosis and on management of elderly STEMI patients. A single-center experience. Expert Review of Hematology, 10(sup1), 1–40. https://doi.org/10.1080/17474086.2017.1399059
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Buioni D., Nardella S., Daniele Maselli D. Effect of Sucrosomial® iron in early time after cardiac surgery. Expert Review of Hematology, 10(sup1), 1–40. https://doi.org/10.1080/17474086.2017.1399059
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Vallerio P, Stucchia M. SiricoD., Buono A., inaldia I., Palazzina M., Giannattasio C. Sucrosomial® Iron and aortic stiffness in cirrhotic patients. Expert Review of Hematology, 9(sup1), 1–42. https://doi.org/10.1080/17474086.2016.1217153
Venturini E., Giallauria F., Cost-effectiveness analysis of ferric carboxymaltose (FCM) versus sucrosomial iron (SI) for the treatment of iron deficiency anemia (IDA) after cardiac surgery. European Journal of Preventive Cardiology, Volume 30, Issue Supplement_1, June 2023, zwad125.166, https://doi.org/10.1093/eurjpc/zwad125.166

Cardiology and Cardiothoracic Surgery

The impact of Iron Deficiency in Cardiology and Cardiac Surgery

Other relevant nutritional deficiencies in cardiology: vitamins D3 and B12

Iron and vitamin supplementation: what cardiovascular research says

Published clinical studies on the use of Sucrosomial® Iron in cardiology and cardiac surgery:

Insights: