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Iron Deficiency in Acute Decompensated Heart Failure
Anna Beale1,2,3, Davis Carballo4, Jerome Stirnemann5
1Baker Heart & Diabetes Institute, 70 Commercial Rd, Melbourne (VIC) 3004, Australia. anna.beale@baker.edu.au.
Journal of Clinical Medicine
|October 5, 2019
Summary
Iron deficiency (ID) is common in heart failure patients. In heart failure with preserved ejection fraction (HFpEF), ID significantly increases hospital length of stay (LOS).
Area of Science:
- Cardiology
- Internal Medicine
- Biochemistry
Background:
- Iron deficiency (ID) is prevalent in patients with acutely decompensated heart failure (ADHF).
- The clinical implications of ID in different heart failure phenotypes, specifically heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), require further characterization.
Purpose of the Study:
- To investigate the prevalence of ID in ADHF patients.
- To determine the association between ID and clinical outcomes, including length of stay (LOS), dyspnea class, biomarkers, and diastolic function.
Main Methods:
- A prospective study of consecutive ADHF patients admitted to a tertiary center.
- Patients were classified as having absolute or functional ID based on ferritin and transferrin saturation levels.
- Demographic, clinical, laboratory, and echocardiographic data were collected and analyzed.
Main Results:
- ID was present in 54% of HFrEF and 56% of HFpEF patients.
- In HFpEF patients, ID was associated with a significantly longer LOS (11 ± 7.7 days vs. 9 ± 6 days, p=0.036).
- ID remained an independent predictor of increased LOS in HFpEF after multivariate analysis.
Conclusions:
- Iron deficiency is highly prevalent in both HFrEF and HFpEF.
- ID is associated with a prolonged hospital length of stay specifically in patients with HFpEF.
- These findings suggest a potentially more significant role of iron deficiency in the pathophysiology and clinical course of HFpEF.
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