Screening & Diagnosis
The 2021 ESC guidelines for the diagnosis and treatment of acute and chronic HF recommend that all patients with HF should be periodically screened for anaemia and iron deficiency2
Iron status should be checked in all patients with suspected chronic HF2
All patients with HF should be periodically screened for anaemia and iron deficiency with a full blood count, serum ferritin concentration and TSAT2
- The defined cut-off values in HF for serum ferritin concentration and TSAT are: serum ferritin of <100 μg/L or 100–299 μg/L with TSAT <20%2
- Note that haemoglobin is not the correct marker to identify iron deficiency. However, low haemoglobin could be caused by iron deficiency2
Recommendations for diagnostic tests in all patients with suspected chronic HF

Recommendation – Class I/Level of evidence C2
Routine blood tests for comorbidities, including full blood count, urea and electrolytes, thyroid function, fasting glucose and HbA1c, lipids, iron status (TSAT and ferritin)


Recommendation – Class I/Level of evidence C2
It is recommended that all patients with HF are periodically screened for anaemia and iron deficiency with a full blood count, serum ferritin concentration and TSAT

References & footnotes
Abbreviations
ESC, European Society of Cardiology; HbA1c, glycated haemoglobin; HF, heart failure; ID, iron deficiency; IV, intravenous; TSAT, transferrin saturation.
References
- Ferinject UAE SmPC. Ferinject KSA SmPC.
- McDonagh TA et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42(36):3599–726.
- McDonagh TA et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2023;44(37):3627–39.





