Skip to content
Research Article Open access CC BY 3.0

Iron Deficiency is an Ominous Predictor of Mortality in Elderly Patients with Stable Heart Failure: a Community Based Study

S. Ghosh, W. T. M. Robertson, C. Zhang, J. Smith, J. Dexter, N. I. O’Kelly

Cardiology and Angiology: An International Journal · pp. 347–355 · Published 7 Aug 2014

10.9734/CA/2014/9811

Abstract

Background: Iron deficiency (ID) has been shown to be linked with poor outcomes within heart failure (HF) populations in previous clinical trials. The impact of ID has not been evaluated in stable chronic heart failure (HF) patients in the community. Our objective was to study the role of ID in stable HF patients and its impact on short term survival. Methods: In this study we analysed 512 patients with stable HF under the care of a regional nurse-led community heart failure team. The study started in June 2007 and ended in June 2010. Results: There were 92% of patients on loop diuretics; 83% on ACE Inhibitors, 92% on b-blockers and 48% on aldosterone antagonists. Mean age of the patients was 77.9 years, 43% were females and mean NYHA class was 2.2. Absolute Iron deficiency (ID) and anemia were defined as ferritin <100µg/L and hemoglobin (Hb)<12g/dl, respectively. Mean Hb levels were 14.1; 13.9; 14.0 and 13.7g/dL at 0, 6, 12 and 24 months. Mean serum ferritin levels in the entire study population were 212µg/L at the start, and 197µg/L at the end. The prevalence of ID and anemia was 21.3% and 9.4%at the start, and was 21.5% and 8.4% at the end of the study. The prevalence of ID was 63%vs. 19% in subjects with vs. without anemia [p<0.001]. Risk-adjusted hazard ratios for 24-month mortality were 1.42 (95% confidence interval: 1.09-1.98) for ID and 1.05 (95% confidence interval; 0.87-1.51) for anemic patients respectively.  Conclusions: In our study, ID was prevalent in stable HF patients in the community and was linked with poor clinical outcomes. In addition, ID was a predictor for mortality than additionally to anemia.  

Iron heart failure community

References (31)

  1. 1 Anemia of Chronic Disease [DOI]
  2. 2 Disorders of Iron Metabolism [DOI]
  3. 3 Ferric Carboxymaltose in Patients with Heart Failure and Iron Deficiency [DOI]
  4. 4 Nutritional iron deficiency [DOI]
  5. 5 The epidemiology of heart failure [DOI]
  6. 6 Anemia Is Common in Heart Failure and Is Associated With Poor Outcomes [DOI]
  7. 7 Anemia and Mortality in Heart Failure Patients [DOI]
  8. 8 Regulation of Iron Metabolism by Hepcidin [DOI]
  9. 9 Iron deficiency in chronic heart failure: An international pooled analysis [DOI]
  10. 10 Effect of Intravenous Iron Sucrose on Exercise Tolerance in Anemic and Nonanemic Patients With Symptomatic Chronic Heart Failure and Iron Deficiency [DOI]
  11. 11 Iron uptake and metabolism in the new millennium [DOI]
  12. 12 Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency [DOI]
  13. 13 Etiology of Anemia in Patients With Advanced Heart Failure [DOI]
  14. 14 An update on iron physiology [DOI]
  15. 15 Iron metabolism in the anemia of chronic disease [DOI]
  16. 16 Mammalian iron transport [DOI]
  17. 17 The Heart Failure Epidemic [DOI]
  18. 18 Intravenous Iron Alone for the Treatment of Anemia in Patients With Chronic Heart Failure [DOI]
  19. 19 Blunted erythropoietin production and defective iron supply for erythropoiesis as major causes of anaemia in patients with chronic heart failure [DOI]
  20. 20 Anemia and Change in Hemoglobin Over Time Related to Mortality and Morbidity in Patients With Chronic Heart Failure [DOI]
  21. 21 A precious metal: Iron, an essential nutrient for all cells [DOI]
  22. 22 Iron deficiency anemia: diagnosis and management [DOI]
  23. 23 Iron and anemia in human biology: a review of mechanisms [DOI]
  24. 24 Echocardiography in chronic heart failure in the community [DOI]
  25. 25 Crusade for iron: iron uptake in unicellular eukaryotes and its significance for virulence [DOI]
  26. 26 Anemia, Renal Dysfunction, and Their Interaction in Patients With Chronic Heart Failure [DOI]
  27. 27 Oxygen‐binding haem proteins [DOI]
  28. 28 Hepcidin in anemia of chronic heart failure [DOI]
  29. 29 Iron homeostasis in chronic inflammation [DOI]
  30. 30 Need and prospects for prevention of cardiac failure.
  31. 31 Anaemia and heart failure [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

54

Page views

0

PDF downloads

37

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.