Long-term effects of iron deficiency in patients with heart failure with or without anemia: the RAID-HF follow-up...

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Iron deficiency (ID) is a common comorbidity in heart failure with reduced ejection fraction (HFrEF).
• Diagnostic and therapeutic focus on ID is often limited to patients with anemia.
• The clinical significance of ID in HFrEF, particularly in non-anemic patients, requires further investigation.

Purpose of the Study:

• To investigate the impact of iron deficiency on long-term mortality and quality of life in patients with HFrEF.
• To assess the prevalence and impact of anemia in patients with HFrEF and ID.
• To evaluate the current clinical practice regarding iron supplementation in HFrEF patients with ID.

Main Methods:

• The RAID-HF registry included consecutive patients with ID and HFrEF from 11 German and Swiss heart centers.
• Analysis focused on 1-year follow-up data, comparing patients with and without anemia.
• Statistical analysis included survival analysis and adjusted models to assess predictors of mortality.

Main Results:

• Patients with HFrEF and ID exhibited higher long-term mortality (19.5% vs. 13.7%) and lower quality of life compared to those without ID.
• Iron supplementation was underused, with only 9.3% receiving it, and 4.7% intravenously.
• ID predicted mortality in non-anemic HFrEF patients (HR 2.15), but not in anemic patients.

Conclusions:

• Iron deficiency significantly impacts long-term mortality and quality of life in HFrEF patients.
• There is a notable underuse of iron supplementation in clinical practice for HFrEF patients with ID.
• Identifying ID in non-anemic HFrEF patients is crucial for risk stratification and potentially improving outcomes.