{
  "abstract": "Introduction Iron deficiency (ID) in heart failure (HF) is linked to reduced functional capacity, muscle dysfunction, and frailty, even without anaemia. Intravenous (IV) iron, is recommended to alleviate symptoms, enhance quality of life and potentially reduce hospitalisations. Ferric carboxymaltose (FCM), a commonly used IV iron formulation, has been associated with hypophosphataemia. The UK MHRA advises phosphate monitoring in patients receiving multiple high-dose infusions or with risk factors such as vitamin D deficiency, calcium and phosphate malabsorption, IBD, osteoporosis, or secondary hyperparathyroidism. This study assessed hypophosphataemia incidence in HF patients treated with FCM.Methods A retrospective, single-center analysis was conducted on HF patients receiving FCM via outpatient rapid response services between October 2023 and November 2024. Data on demographics, HF classification, treatment, and biochemical monitoring were collected from the Northern Ireland Electronic Care Record (NIECR).Results Fifty-six patients, mean age 71.7 years (IQR 64.5–81), 62.5% male, were included. Median eGFR was 60 mL/min/1.73m 2 (IQR45–60), median NTProBNP 1160 ng/L (IQR 626–3975). HF phenotypes: 73.2% HFrEF, 8.9% HFmrEF, 1.8% recovered EF, 16.1% HFpEF. Ten patients met MHRA criteria—eight due to multiple infusions, two due to osteoporosis. Of these, 70% underwent phosphate monitoring (figure1). One developed mild, self-resolving hypophosphataemia (figure2). No fractures or osteomalacia were observed.Discussion Although many patients met criteria for phosphate monitoring, clinically significant hypophosphataemia was not identified. FCM-induced hypophosphataemia may involve fibroblast growth factor 23 (FGF23) activity. In contrast to IBD cohorts, HF patients in our study experienced no notable complications. Our findings align with large HF trials (FAIR-HF, CONFIRM-HF, AFFIRM-AHF, HEART-FID, FAIR-HF2), which also reported no major safety concerns regarding phosphate levels.Conclusion While hypophosphataemia is a recognised risk with FCM, it was infrequent and mild in this HF cohort. IV iron decisions should be patient-centered, considering risk factors, need for monitoring, and convenience of dosing.Abstract 63 Figure 1Abstract 63 Figure 2",
  "authors": [
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "L Cox"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "K Mooteeram"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "T Morton"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "G Pyla"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "E Lee"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "S O’Hara"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK"
      ],
      "name": "T Thompson"
    },
    {
      "affiliations": [
        "South West Acute Hospital, Enniskillen, UK",
        "School of Medicine, Dentistry and Biomedical Sciences, QUB, Belfast, UK",
        "Royal College of surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin, Ireland"
      ],
      "name": "M Monaghan"
    }
  ],
  "title": "63 Iron deficiency in ambulatory heart failure patients: evaluating the role of hypophosphataemia risk in selecting intravenous iron therapy",
  "uid": "fb5e3444-8829-54ba-837d-dbd25477b166"
}