Changes in platelet count as a marker of myocardial iron uptake after administration of ferric carboxymaltose in patients with heart failure

Résumé fourni par la source

Iron deficiency (ID) treated with ferric carboxymaltose (FCM) previously showed reduced platelet count; however, no studies have evaluated its biological significance in heart failure. In the current study, we aimed to: (a) assess the changes in platelet count at 7 and 30 days post-FCM, and (b) explore its association with non-invasive surrogates of myocardial iron uptake and left systolic function in patients with ID and heart failure with left ventricular ejection fraction < 50% (HFrEF and HFmrEF). This post-hoc analysis of a randomized, double-blind, FCM vs. placebo clinical trial (Myocardial-IRON Trail) involved 45 outpatients with HFrEF and HFmrEF and ID in which the platelet count value was available. Platelet count, cardiac magnetic resonance T1-mapping and 3D-global longitudinal strain (CMR-GLS) were assessed at baseline, 7, and 30 days. Linear regression models were used to evaluate the between-treatment differences and endpoints. The mean (SD) age was 71 ± 8 years, and 32 (71%) were men. At 30 days, we found a significant reduction in platelet count in those treated with FCM (p-value = 0.027). In those treated with FCM, the greater 30-day decrease in platelets showed lower 30-day changes in T1-mapping (p = 0.024) and CMR-GLS (p = 0.028). After administration of FCM, we found a significant 30-day reduction in platelet count. The greater platelet count reduction was related to lower myocardial iron repletion and a smaller improvement in left ventricular systolic function.

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