Efficacy and Safety of Lactoferrin in Heart Failure Patients

Inclusion Criteria

• •1. Age: 18-65 years old.
• •2. Chronic heart failure (\> 6 months duration) with reduced ejection fraction defined as LVEF ≤ 40%.
• •3. NYHA-class II or III or IV with stable symptoms for at least the past 3 months.
• •4. Stabilized on beta blockers, renin-angiotensin system inhibitor (ACEI/ARB) or angiotensin receptor-neprilysin inhibitors (ARNIs), mineralocorticoid receptor antagonists (MRAs) and sodium-glucose co-transporter 2 Inhibitors (SGLT2i) and diuretics as needed.
• •5. No dose changes of heart failure drugs during the last 2 weeks (exception: diuretics)
• •6. No introduction of a new heart failure drug class during the last 4 weeks.
• •7. Iron deficiency: serum ferritin level of 15 to 100 ng/mL or a serum ferritin level of 101 to 299 ng/mL with transferrin saturation of less than 20%.