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Beyond the Guidelines: The Critical Role of Type 1 Iron Deficiency in Predicting Mortality in Patients with Heart

Tuğce Çolluoğlu1, Tuğba Kapanşahin1, Yeşim Akın1

  • 1Department of Cardiology, Karabük University, Faculty of Medicine, Karabük, Türkiye.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|June 3, 2025
PubMed

Insights

Type 1 iron deficiency (ID) in heart failure (HF) patients predicts higher mortality. This specific type of ID, unlike others, independently increases the risk of death within one year for those with HF.

Area of Science:

  • Cardiology
  • Hematology
  • Internal Medicine

Background:

  • Iron deficiency (ID) is common in heart failure (HF) and may indicate poor prognosis.
  • Existing criteria for ID may not fully capture the risk associated with depleted iron stores in HF patients.

Purpose of the Study:

  • To investigate the prognostic value of newly defined types of iron deficiency in patients with heart failure.
  • To determine if specific ID classifications predict one-year all-cause mortality in HF.

Main Methods:

  • 570 heart failure patients were categorized into Type 1 ID (low transferrin saturation with anemia), Type 2 or 3 ID (low transferrin saturation with no/mild anemia), and guideline-defined ID.
  • Logistic and Cox regression analyses were used to identify predictors of one-year all-cause mortality.

Main Results:

  • Type 1 ID was present in 30.7% of patients, Type 2 or 3 in 43.9%, and guideline ID in 72.8%.
  • One-year mortality rates were 38.3% for Type 1 ID, 22.7% for Type 2 or 3 ID, and 26.0% for guideline ID.
  • Type 1 ID (OR: 1.830) and increased age were independent predictors of one-year mortality.

Conclusions:

  • Type 1 iron deficiency is a significant independent predictor of one-year all-cause mortality in heart failure patients.
  • This contrasts with Type 2/3 ID and guideline-defined ID, suggesting Type 1 ID carries a distinct prognostic implication in HF.
Abstract

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