Discussion
HF, iron deficiency, AHF, diabetes
DISEASE, IRON DEFICIENCY, DIABETES
This post hoc analysis of the AFFIRM-AHF trial showed that the benefits of IV FCM vs placebo for reducing cardiovascular outcomes (including HF hospitalizations) and improving QoL in patients with iron deficiency following stabilization of an AHF episode were irrespective of diabetes status.Multiple studies have reported greater morbidity and mortality in patients with HF and diabetes than in patients with HF and no diabetes [Many treatments have shown similar effectiveness in patients with HF regardless of the presence or absence of concomitant diabetes [Despite the higher disease burden and frequency of comorbidities in patients with vs without diabetes, no differences were observed in KCCQ-12 OSS or CSS at baseline. This finding was surprising and in contrast with previous reports of impaired QoL scores in patients with diabetes and HF compared with those without diabetes [Levels of serum ferritin, Hb, and TSAT increased in all treatment arms and subgroups over time, but were increased to a significantly greater magnitude with FCM vs placebo in patients with and without diabetes. This suggests that some spontaneous recovery of iron parameters occurs without iron supplementation following an AHF episode in patients with and without diabetes, but that FCM allows recovery to a greater level in both cases. Changes in iron parameters over time mirrored the improvements in disease-specific QoL, aligning with the well-established relationship between iron deficiency and QoL [Rates of AEs were higher in patients with diabetes compared with those without diabetes, in alignment with the greater disease burden in the former subgroup at baseline. In patients with diabetes, rates of AEs, including treatment-associated AEs and serious AEs, were numerically lower in patients treated with FCM compared with placebo. This may reflect an improvement in overall health following FCM treatment in patients with diabetes.Several limitations relating to the post hoc