Iron Deficiency Definition in HF — EECC MCQ

Correct answer: C — Yes — iron deficiency in HF is defined as ferritin <100 OR ferritin 100-299 with TSAT <20%; he meets criteria (ferritin 100-299 with TSAT <20%) and should receive IV iron

Iron deficiency in HF has a specific definition that differs from general iron deficiency: ferritin <100 microg/L (absolute iron deficiency) OR ferritin 100-299 microg/L with TSAT <20% (functional iron deficiency). This definition captures patients who have adequate storage iron but impaired iron utilisation. This patient's ferritin of 180 with TSAT 18% meets the functional iron deficiency definition. The ESC HF Guidelines (Class I, LOE A) recommend IV iron replacement (ferric carboxymaltose or ferric derisomaltose) to improve symptoms, exercise capacity, and quality of life. Oral iron is poorly absorbed in HF and is not recommended.

Reference: ESC (2023): Focused Update on Heart Failure