Heart failure & cardiomyopathiesCohort study
Associations of Iron Deficiency with Cardiac Function, Congestion, Exercise Capacity and Prognosis in Heart Failure
- Cohort study
Authors' conclusion
TSAT <20% and iron ≤13 μmol/L, but not G-ID or ferritin-based ID, predict a worse prognosis in HF outpatients with preserved and reduced LVEF.
Study context
- Population
- Heart failure (HF) outpatients (72% with LVEF ≥50%)
- Participants
- 1,502 outpatients
- Exposure
- Different iron deficiency definitions
- G-IDn = 728
- TSAT <20%n = 471
- Outcome
- Relationship of ID definitions with cardiac structure/function, congestion, exercise capacity and prognosis (HF hospitalizations or all-cause mortality)
- Follow-up
- Median 18 months
Main finding
As reported in the abstract
HF hospitalization or all-cause mortality · median 18 months
Hazard ratio (95% CI)
TSAT <20%
2.48(1.88–3.17)
Iron ≤13 μmol/L
1.93(1.48–2.52)
Observational data: associations, not effects.
Further findings
Peak oxygen uptake
- TSAT directly associated with peak oxygen uptake (standardized coefficient), adjusted incl. haemoglobin
- 0.069, p = 0.041
- Ferritin not associated
- no interaction with HF phenotype (HFpEF vs HFrEF)
Congestion by ultrasound
- Lower TSAT, iron and haemoglobin, but not ferritin, associated with more signs of congestion
Cardiac structure and function
- TSAT <20% or G-ID: greater left atrial volume but similar LVEF
Original publication
Associations of Iron Deficiency with Cardiac Function, Congestion, Exercise Capacity and Prognosis in Heart Failure. Eur J Heart Fail. Published 28 November 2024. doi:10.1002/ejhf.3534
Summarised from the published abstract; every number is checked against it