Iron deficiency in chronic heart failure: an international pooled analysis

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Ijsbrand T Klip1, Josep Comin-Colet, Adriaan A Voors

  • 1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

American Heart Journal
|March 30, 2013
PubMed

Insights

Iron deficiency is common in heart failure patients and predicts mortality. Addressing iron deficiency may improve outcomes, showing greater predictive power than anemia alone.

Area of Science:

  • Cardiology
  • Hematology
  • Internal Medicine

Background:

  • Iron deficiency (ID) is an emerging concern in chronic heart failure (HF).
  • The prevalence, predictors, and prognostic impact of ID in chronic HF remain incompletely understood.
  • ID presents a potential therapeutic target in HF management.

Purpose of the Study:

  • To investigate the prevalence, clinical associates, and prognostic consequences of iron deficiency in patients with chronic heart failure.
  • To compare the predictive power of iron deficiency versus anemia for mortality in this population.

Main Methods:

  • An international pooled cohort of 1,506 patients with chronic HF was analyzed.
  • Iron deficiency was defined by ferritin and transferrin saturation levels.
  • Prognostic outcomes, including mortality, were assessed over a median follow-up of 1.92 years.

Main Results:

  • Iron deficiency was present in 50% of patients, more common in anemic individuals.
  • Predictors of ID included higher NYHA class, elevated NT-proBNP, lower MCV, and female sex.
  • ID, but not anemia, was a strong independent predictor of mortality (HR 1.42, P = .002) and improved risk classification.

Conclusions:

  • Iron deficiency is highly prevalent in chronic heart failure patients.
  • ID is associated with disease severity and is a significant independent predictor of mortality.
  • Iron deficiency demonstrates greater prognostic value than anemia in chronic heart failure.
Abstract

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