Relationship between iron homeostasis and prognosis in patients with heart failure: a retrospective study based on
Yuanhang Cai1,2, Hao Jin2,3, Lili Wang4
1College of Information Engineering, Dalian University, Dalian, China
Insights
Iron homeostasis indicators significantly impact heart failure (HF) patient prognosis. High ferritin and serum iron correlate with poor outcomes, while transferrin and total iron binding capacity (TIBC) indicate better survival, aiding risk stratification.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Iron homeostasis is crucial for heart failure (HF) patient prognosis.
- Imbalances in iron, including deficiency and overload, significantly affect HF outcomes and management.
Purpose of the Study:
- To investigate associations between iron homeostasis indicators and mortality in HF patients.
- To assess the predictive value of iron indicators for HF patient prognosis.
Main Methods:
- Retrospective analysis of 3483 HF patients from the MIMIC-IV database.
- Utilized Cox proportional hazards model and Kaplan-Meier survival analysis.
- Assessed predictive capability using receiver operating characteristic curves for indicators: ferritin, serum iron, transferrin, and total iron binding capacity (TIBC).
Main Results:
- Elevated ferritin and serum iron levels (fourth quartile) were linked to worse long-term outcomes in HF patients.
- Higher transferrin and TIBC levels (fourth quartile) were associated with reduced mortality.
- Iron homeostasis indicators demonstrated predictive value for both long-term and first-admission mortality.
Conclusions:
- Iron homeostasis indicators are significantly associated with HF patient prognosis.
- Findings offer insights for risk stratification and clinical decision-making in HF management.
- Future research should explore dynamic iron fluctuations and therapeutic interventions for HF patients.
Introduction:
The role of iron homeostasis has become increasingly recognized as a key factor in determining a prognosis of patients with heart failure (HF). Disruptions in iron balance, encompassing deficiency and overload, can affect patient prognosis, and therefore, significantly impact treatment and management strategies.
Objectives:
The study investigated possible associations between iron homeostasis-related indicators and long‑term mortality as well as first‑admission mortality in individuals with HF.
Patients And Methods:
Data on 3483 HF patients from the MIMIC‑IV database were retrospectively analyzed. The relationship between iron homeostasis-related indicators (ferritin, serum iron, transferrin, and total iron binding capacity [TIBC]) and the first-admission and long-term mortality of HF patients was discerned utilizing the Cox proportional hazards model and the Kaplan-Meier survival analysis. Additionally, the predictive capability of these indicators for patient prognosis was assessed using the receiver operating characteristic curve.
Results:
Fourth quartile levels of ferritin and serum iron were obviously associated with poor long‑term outcomes in HF patients. Conversely, fourth quartile levels of transferrin and TIBC served as protective factors and were associated with a lower mortality. Additionally, iron homeostasis indicators exhibited a certain predictive value for both long‑term mortality and first‑admission mortality in HF patients.
Conclusions:
This study underscores a significant association between iron homeostasis indicators and the prognosis of HF patients, providing valuable insights into risk stratification and clinical decision‑making for this population. Future studies should focus on dynamic fluctuations in iron homeostasis and explore interventions to improve the prognosis of HF patients.
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