Iron deficiency in patients of heart failure with reduced ejection fraction

Heart Failure with reduced Ejection Fraction (HFrEF) is a common disorder affecting a large population. Iron deficiency (ID) with and without anaemia is an important variable which is often underreported and under treated in clinical practice, which contributes to patient symptoms. The present study was undertaken to study the prevalence and Spectrum of Iron Deficiency in patients of HFrEF.

This is a single-centre observational study. All patients with a clinical diagnosis of HFrEF presenting to the hospital were studied. Ejection Fraction (EF) was assessed on Echo and ID was diagnosed on basis of serum ferritin <100 micro g/dl or serum ferritin 100-300 micro g/dl with low Transferrin Saturation (TSAT) (< 20%).

We have studied a total of 204 patients with a predominantly male population (73%) and a mean age of 62.88 years. Most of our patients were in mid-level functional class (mean 2.48 ± 0.50) and had low EF (mean 29.56 ± 6.52). Out of 204 patients, 88.7% patients had ID with 83% patients having absolute ID. Of the total patients with HF, 70% had anaemia. Amongst those with anaemia 93% had ID, and even without anaemia, 68% had absolute or functional ID, underlying the importance of evaluating iron status in all patients of HF irrespective of their haemoglobin levels.

This study highlights the burden of iron deficiency in heart failure patients in the Indian population and opens the way for large scale studies for better characterization of iron deficiency as well as therapeutic trials in the management of heart failure patients.