Abstract | AIMS: METHODS AND RESULTS: Prospective cohort of patients with CHF attending a clinic serving a large local population. A total of 4422 patients were included (median age 75 (68-82) years; 40% women; 32% with left ventricular ejection fraction ≤40%). STC ≤ 2.3 g/L (lowest quartile) was associated with older age, lower SIC and haemoglobin and higher high-sensitivity C-reactive protein, ferritin and N-terminal pro- brain natriuretic peptide compared with those with STC > 2.3 g/L. In the lowest STC quartile, 624 (52%) patients had SIC ≤13 μmol/L, of whom 38% had TSAT ≥20%. For patients in the highest STC quartile, TSAT was <20% when SIC was >13 μmol/L in 185 (17%) patients. STC correlated inversely with ferritin (r = -0.52) and high-sensitivity C-reactive protein (r = -0.17) and directly with albumin (r = 0.29); all P < 0.001. In models adjusted for age, N-terminal pro- brain natriuretic peptide and haemoglobin, both higher SIC (hazard ratio 0.87 [95% CI: 0.81-0.95]) and STC (hazard ratio 0.82 [95% CI: 0.73-0.91]) were associated with lower mortality. SIC was more strongly associated with both anaemia and mortality than either STC or TSAT. CONCLUSIONS: Many patients with CHF and a low STC have low SIC even when TSAT is >20% and serum ferritin >100 μg/L; such patients have a high prevalence of anaemia and a poor prognosis and might have iron deficiency but are currently excluded from clinical trials of iron repletion.
|
Authors | Fraser J Graham, Pierpaolo Pellicori, Gabriele Masini, Joseph J Cuthbert, Andrew L Clark, John G F Cleland |
Journal | ESC heart failure
(ESC Heart Fail)
Vol. 10
Issue 5
Pg. 2826-2836
(10 2023)
ISSN: 2055-5822 [Electronic] England |
PMID | 37400990
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. |
Chemical References |
- C-Reactive Protein
- Ferritins
- Hemoglobins
- Iron
- Transferrin
|
Topics |
- Aged
- Female
- Humans
- Male
- Anemia
- Anemia, Iron-Deficiency
(complications, diagnosis)
- C-Reactive Protein
- Chronic Disease
- Ferritins
(metabolism)
- Heart Failure
(complications, diagnosis)
- Hemoglobins
- Iron
(metabolism)
- Iron Deficiencies
- Prospective Studies
- Stroke Volume
- Transferrin
(metabolism)
- Ventricular Function, Left
- Aged, 80 and over
|