A new study suggests assessing iron status in patients admitted to hospital for worsening heart failure, regardless of gender, decompensated heart failure severity, or haemoglobin level.
Decompensated heart failure is defined as a sudden worsening of symptoms in chronic heart failure patients, often requiring hospitalisation. Although iron deficiency is associated with poor outcomes in patients with chronic heart failure, its prevalence is unknown in those with decompensated heart failure, and screening for iron deficiency is uncommon, especially in those without anaemia or in an acute setting.
In this study, iron parameters of patients hospitalised for decompensated chronic heart failure were assessed during the 72 hours after hospital admission. Iron deficiency was defined according to the 2012 European Society of Cardiology Guidelines (serum ferritin <100 m/L or ferritin concentration 100–299 mg/L and transferrin saturation <20%)1, and anaemia as haemoglobin <13 g/dL in men and <12 g/dL in women.
Amongst 832 patients, the prevalence of iron deficiency was 69% and 75% in men and women respectively. Anaemia was seen in 68% of men and 52% of women. Among non-anaemic patients, the prevalence of iron deficiency was 57 and 79%. Approximately 9% of all patients included in the analyses received iron therapy for treatment of iron deficiency at the time of admission (oral, 9%; intravenous, 0.2%).
Iron deficiency was independently associated with anaemia and anti-platelet treatment in men, and diabetes and low C-reactive protein in women. However, iron deficiency was not related to heart failure severity, as assessed by left ventricular ejection fraction, New York Heart Association functional class, or plasma levels of N-terminal prohormone of brain natriuretic peptide.
Iron deficiency is common in patients admitted for acute decompensated heart failure, even among non-anaemic patients. The authors suggest that the results emphasize the need to assess iron status not only in chronic heart failure patients, but even more so in those admitted for worsening heart failure, regardless of gender, heart failure severity, or haemoglobin level.
The full article is available in the September issue of the European Journal of Heart Failure. For information on iron deficiency in patients with heart failure, please click here.