Heart failure & cardiomyopathies
Prevalence and Prognostic Value of Different Iron Deficiency Definitions in Light Chain Cardiac Amyloidosis Patients
Authors' conclusion
Different definitions of ID yield inconsistent results in terms of prevalence and prognosis. ID, as defined by TSAT < 20% or serum iron < 13 μmol/L, rather than the guideline definition, emerged as an independent predictor of all-cause mortality in patients with AL-CM.
Study context
- Population
- Patients diagnosed with light chain cardiac amyloidosis (AL-CM) at Heart Failure Center, Fuwai Hospital between September 2017 and October 2023patients included, 60 (40.3%) female, 127 (85.2%) New York Heart Association (NYHA) class III–IV, 136 (91.3%) revised Mayo 2012 stage III–IV
- Participants
- 149 patients
- Comparison
- Iron deficiency (ID) vs no ID under three different ID definitions, for prevalence and association with all-cause mortality
- ID (guideline definition)n = 63
- ID (transferrin saturation (TSAT) < 20%)n = 61
- ID (serum iron <13 μmol/L)n = 105
- Outcome
- All-cause mortality
Main finding
As reported in the abstract
Estimate (95% CI)P value
ID (TSAT < 20%)unadjusted; higher mortality with ID
HR 2.14(1.36–3.37)
P < 0.001ID (serum iron <13 μmol/L)unadjusted; higher mortality with ID
HR 2.16(1.23–3.80)
P < 0.01ID (guideline definition)unadjusted; association not seen
HR 1.39(0.88–2.18)
P = 0.158ID (TSAT < 20%)adjusted for age, gender, haemoglobin, and revised 2012 Mayo staging
adjusted HR 2.49(1.54–4.05)
P < 0.001ID (serum iron <13 μmol/L)adjusted for age, gender, haemoglobin, and revised 2012 Mayo staging
adjusted HR 2.24(1.23–4.09)
P < 0.01Further findings
Prevalence of ID by definition
- Prevalence of ID by definition: P < 0.0001
Iron biomarkers
- Median ferritin
- 183.68 ng/mL (interquartile range [IQR] 95.48, 339.01)
- Median TSAT
- 21.80% (IQR 16.34, 29.48)
- Median serum iron
- 10.87 μmol/L (IQR 7.38, 13.71)
- Correlation of serum iron with TSAT
- r = 0.85, P < 0.0001
Original publication
Prevalence and Prognostic Value of Different Iron Deficiency Definitions in Light Chain Cardiac Amyloidosis Patients. ESC Heart Fail. Published 8 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it