Heart failure & cardiomyopathies
Prognostic Impact of Iron Deficiency in New-Onset Chronic Heart Failure: Danish Heart Failure Registry Insights
Authors' conclusion
ID, when defined by TSAT < 20% or serum iron ≤13 μmol/L, is associated with increased risk of all-cause and cardiovascular mortality, as well as first hospitalization for HF in patients with new-onset chronic HF, regardless of anaemia status. Conversely, ID defined as ESC guidelines is associated with all-cause and cardiovascular mortality only in non-anaemic patients.
Study context
- Population
- Patients with new-onset chronic Heart Failure (HF), Danish Heart Failure Registry, April 2003 to December 2019
- Participants
- 9,477 patients
- Exposure
- Four definitions of iron deficiency (ID) vs no ID
- Outcome
- Prevalence of ID and its association with all-cause mortality, CV mortality and first hospitalization for HF
Methodological detailsnationwide, registry-based
- Nationwide
- Registry-based
Main finding
As reported in the abstract
Prevalence of ID and association of ID definitions with all-cause mortality, CV mortality and first HF hospitalization, by anaemia status
Hazard ratio (95% CI)
TSAT <20% vs No IDall-cause mortality, non-anaemic
1.57(1.30–1.89)
Serum iron ≤13 μmol/L vs No IDall-cause mortality, non-anaemic
1.47(1.24–1.73)
TSAT <20% vs No IDall-cause mortality, anaemic
1.22(1.07–1.38)
Serum iron ≤13 μmol/L vs No IDall-cause mortality, anaemic
1.25(1.09–1.44)
TSAT <20% vs No IDCV mortality, non-anaemic
2.21(1.59–3.06)
Serum iron ≤13 μmol/L vs No IDCV mortality, non-anaemic
1.47(1.12–1.95)
TSAT <20% vs No IDCV mortality, anaemic
1.37(1.11–1.69)
Serum iron ≤13 μmol/L vs No IDCV mortality, anaemic
1.28(1.02–1.61)
Serum iron ≤13 μmol/L vs No IDfirst HF hospitalization, non-anaemic
1.27(1.10–1.46)
TSAT <20% vs No IDfirst HF hospitalization, anaemic
1.25(1.08–1.44)
Serum iron ≤13 μmol/L vs No IDfirst HF hospitalization, anaemic
1.22(1.05–1.42)
ESC definition vs No IDCV mortality, non-anaemic only
1.58(1.18–2.12)
ESC definition vs No IDfirst HF hospitalization, anaemic
1.34(1.17–1.53)
HR
- Transferrin saturation (TSAT) <20% vs No ID · first HF hospitalization, non-anaemic; CI misprinted in abstract
- 1.28
- European Society of Cardiology (ESC) definition vs No ID · all-cause mortality, non-anaemic only; CI misprinted in abstract
- 1.41
- ESC definition vs No ID · first HF hospitalization, non-anaemic; CI misprinted in abstract
- 1.26
- ID prevalence, depending on definition
- 35.8% to 64.3%
- ID by iron ≤13 μmol/L not meeting ESC definition
- 26%
- ID by TSAT <20% not meeting ESC definition
- 15.5%
- ESC-defined ID with serum iron >13 μmol/L and TSAT >20%
- 11%
Observational data: associations, not effects.
Further findings
Discordance between ID definitions
- Iron ≤13 not meeting ESC definition
- 26%
- TSAT < 20% not meeting ESC definition
- 15.5%
- ESC criteria met with serum iron >13 μmol/L and TSAT > 20%
- 11%
Original publication
Prognostic Impact of Iron Deficiency in New-Onset Chronic Heart Failure: Danish Heart Failure Registry Insights. ESC Heart Fail. Published 6 November 2024. doi:10.
Summarised from the published abstract; every number is checked against it