Heart failure & cardiomyopathies
Iron Deficiency in Heart Failure: Screening, Prevalence, Incidence and Outcome Data from the Swedish Heart Failure Registry and the Stockholm CREAtinine Measurements Collaborative Project
An erratum to this article was published (Eur J Heart Fail, Jul 2024 ↗)
Authors' conclusion
Iron deficiency screening improved over time but is still limitedly implemented, despite being highly prevalent and incident, and independently associated with CV death or HF rehospitalizations regardless of EF.
Study context
- Population
- Patients with heart failure (HF) across the ejection fraction (EF) spectrum, Region Stockholm1,486 with iron biomarkers
- Participants
- 15,197 patients
- Exposure
- Iron deficiency (ID) vs no ID
- Outcome
- ID prevalence (patients with iron biomarkers at baseline)
- Follow-up
- Baseline
Methodological detailsSwedish HF registry, Region Stockholm
- Swedish HF registry
- Region Stockholm
Main finding
As reported in the abstract
ID prevalence, overall
55%
ID prevalence, HFrEF
54%
ID prevalence, HF with mildly reduced EF
51%
ID prevalence, HFpEF
61%
Observational data: associations, not effects.
Further findings
| Outcome | IRR (95% CI) | |
|---|---|---|
| HF rehospitalizations; CV death or repeated HF hospitalizationsIDvs No IDHF rehospitalizations; interaction P 0.21 · regardless of EF | 1.62 (1.13–2.31) | |
| HF rehospitalizations; CV death or repeated HF hospitalizationsIDvs No IDCV death or repeated HF hospitalizations; interaction P 0.26 · regardless of EF | 1.63 (1.15–2.30) | |
| 0.512Incidence rate ratio (log scale) |
Iron screening
- Iron screening improved since 2016 but remained <25% as of 2018
Iron need ≥1500 mg
- Patients with iron need ≥1500 mg
- 72%
All-cause death, cardiovascular (CV) death, first HF hospitalization
- ID not associated with all-cause death, CV death or first HF hospitalization
ID incidence (96 without ID at baseline, with follow-up biomarkers) · 6 months
- Developed ID within 6 months
- 21%
Original publication
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