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Natural history and prognostic significance of iron deficiency and anaemia in ambulatory patients with chronic heart failure

2021; Elsevier BV; Volume: 24; Issue: 5 Linguagem: Inglês

10.1002/ejhf.2251

1879-0844

Fraser J Graham, G Masini, Pierpaolo Pellicori, John G.F. Cleland, Nicola Greenlaw, Jocelyn Friday, Syed Kazmi, Andrew L. Clark,

Heart Failure Treatment and Management

Iron deficiency (ID) and anaemia are common in heart failure; less is known about changes over time.We investigated prevalence, incidence and resolution of ID and anaemia in 906 patients with chronic heart failure (median age 73 (65-79) years, 70% men, 51% with heart failure with reduced ejection fraction) 1 year apart. ID was defined as serum iron ≤13 µmol/L and anaemia as haemoglobin <13.0 g/dL for men or 13 µmol/L), mortality was higher in those with persistent or incident ID at 1 year [hazard ratio (HR) 1.81 (1.23-2.67), and HR 1.40 (0.91-2.14), respectively] in multivariable models (P = 0.02). Compared to persistent ID, resolution of ID was associated with a lower mortality [HR 0.61 (0.44-0.86); P = 0.004]. Changes in ID defined by FAIR-HF criteria were not similarly associated with mortality. Anaemia was associated with a poor outcome even if it resolved.The prevalence and incidence of ID and anaemia are high in chronic heart failure but so is the rate of resolution. Persistent or incident ID, defined by a serum iron ≤13 µmol/L, is associated with higher mortality and resolution of ID with lower mortality.