A multimodal approach to heart failure of ischemic etiology with anemia and psychological distress
DOI:
https://doi.org/10.14739/2310-1210.2026.4.352897Keywords:
chronic heart failure, ischemic heart disease, iron deficiency anemia, ferric carboxymaltose, depression, anxiety, quality of lifeAbstract
Iron deficiency and anemia are common comorbidities in patients with chronic heart failure (CHF) and are associated with reduced exercise tolerance, impaired quality of life, and poor prognosis. Depression and anxiety are also common and may further worsen clinical outcomes.
Aim. To evaluate the dynamics of hematological and iron metabolism parameters in patients with chronic heart failure of ischemic etiology and iron deficiency anemia treated with intravenous ferric carboxymaltose (FCM), with special attention to the impact of concomitant depressive and anxiety symptoms.
Materials and methods. A prospective observational study was conducted on 57 patients with CHF of ischemic etiology and laboratory-confirmed iron deficiency anemia. All patients received standard CHF therapy and intravenous FCM. Sertraline was added to 23 patients with clinically significant depressive and anxiety symptoms. Hematological parameters, iron parameters, quality of life and psychometric parameters (PHQ-9, GAD-7, SAQ) were assessed at baseline, day 160, and day 340.
Results. Treatment resulted in significant improvements in hemoglobin, ferritin, transferrin saturation and red blood cell count in the cohort. In the subgroup with depressive/anxiety symptoms, improvements were more pronounced: hemoglobin levels increased from 111.6 (106.0; 126.4) g/L to 140.9 (125.7; 156.0) g/L at day 160 and 142.1 (128.5; 159.2) g/L at day 340, while ferritin levels increased from 52.7 (47.5; 59.0) μg/L to 103.8 (90.6; 111.0) μg/L and 116.0 (101.2; 123.9) μg/L, respectively. Depression and anxiety scores (PHQ-9, GAD-7) decreased significantly, which was accompanied by improvements in quality-of-life scores.
Conclusions. Intravenous administration of FCM effectively corrects iron deficiency anemia in patients with CHF of ischemic etiology, resulting in sustained improvements in hematological and clinical parameters. Patients with comorbid depression and anxiety demonstrated more pronounced benefits, likely due to the combined effect of anemia correction and psychotropic support with sertraline. These results support a multidisciplinary approach that integrates cardiological and psychosocial care in the management of CHF.
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