Iron deficiency testing among people with incident heart failure in primary care

Area of Science:

• Cardiology
• Primary Care Medicine
• Clinical Research

Background:

• Iron deficiency affects approximately 50% of heart failure patients, yet screening practices in primary care are not well-understood.
• Current guidelines recommend iron deficiency screening for heart failure patients, but adherence and equity remain uncertain.

Purpose of the Study:

• To determine the proportion of patients diagnosed with heart failure who receive a ferritin test within 12 months of diagnosis.
• To investigate factors associated with ferritin testing in incident heart failure cases.

Main Methods:

• A retrospective cohort study was conducted using the Clinical Practice Research Datalink Aurum database.
• Data from 105,749 adult patients diagnosed with heart failure between 2016 and 2021 were analyzed.
• Multivariable logistic regression was employed to assess the association of demographic factors and comorbidities with ferritin testing.

Main Results:

• Only 33.7% (35,688 out of 105,749) of patients with incident heart failure received a ferritin test within one year.
• Factors associated with increased odds of testing included older age, female sex, Asian ethnicity, and diagnoses of coeliac disease, type 1 diabetes, and cirrhosis.
• Significant geographic variations in testing rates were observed, even after adjusting for covariates.

Conclusions:

• A substantial gap exists in current primary care practice, with two-thirds of new heart failure diagnoses not followed by timely iron deficiency screening.
• These findings indicate a missed opportunity for improving heart failure management through consistent iron deficiency assessment.
• Service delivery improvements are needed to ensure equitable and timely ferritin testing for all heart failure patients.