Arrhythmias & electrophysiology
Prognostic implications of iron deficiency in patients with atrial fibrillation, with and without chronic heart failure
Authors' conclusion
ID defined by TSAT <20% or serum iron ≤13 µmol/L is associated with increased mortality in patients with AF, irrespective of HF status, highlighting these criteria as clinically relevant for risk stratification.
Study context
- Population
- Patients with atrial fibrillation/flutter (AF) who underwent iron studies between 2008 and 2019, stratified by heart failure (HF) statuspatients with AF who underwent iron studies
- Participants
- 10,834 patients
- Exposure
- Associations between iron deficiency (ID) definitions and all-cause mortality, cardiovascular mortality and all-cause hospitalisation
- Outcome
- Prevalence of ID across definitions
Methodological detailsDanish
- Danish
Main finding
As reported in the abstract
Prevalence of ID, range across definitions
36.2% to 62.7%
Observational data: associations, not effects.
Further findings
All-cause and cardiovascular mortality, transferrin saturation (TSAT) <20% · median follow-up of 31 months
| Comparison | HR (95% CI) | |
|---|---|---|
| TSAT <20%All-cause mortality, HF · Cox regression, adjusted for confounders | 1.25 (1.14–1.37) | |
| TSAT <20%Cardiovascular mortality, HF · Cox regression, adjusted for confounders | 1.31 (1.14–1.49) | |
| TSAT <20%All-cause mortality, patients without HF · Cox regression, adjusted for confounders | 1.39 (1.18–1.64) | |
| TSAT <20%Cardiovascular mortality, patients without HF · Cox regression, adjusted for confounders | 1.54 (1.18–2.00) | |
| 0.512Hazard ratio (log scale) |
All-cause and cardiovascular mortality, serum iron ≤13 µmol/L · median follow-up of 31 months
| Comparison | HR (95% CI) | |
|---|---|---|
| Serum iron ≤13 µmol/LAll-cause mortality, HF · Cox regression, adjusted for confounders | 1.44 (1.31–1.58) | |
| Serum iron ≤13 µmol/LCardiovascular mortality, HF · Cox regression, adjusted for confounders | 1.42 (1.24–1.63) | |
| Serum iron ≤13 µmol/LAll-cause mortality, patients without HF · Cox regression, adjusted for confounders | 1.67 (1.41–1.97) | |
| Serum iron ≤13 µmol/LCardiovascular mortality, patients without HF · Cox regression, adjusted for confounders | 1.46 (1.13–1.89) | |
| 0.512Hazard ratio (log scale) |
Mortality and all-cause hospitalisation, European Society of Cardiology (ESC) guidelines or ferritin <100 ng/mL · median follow-up of 31 months
| Comparison | HR (95% CI) | |
|---|---|---|
| ESC guidelinesAll-cause hospitalisation, patients with HF | 1.15 (1.08–1.23) | |
| Ferritin <100 ng/mLAll-cause hospitalisation, patients with HF | 1.16 (1.09–1.23) | |
| 0.512Hazard ratio (log scale) |
- ID defined by ESC guidelines or ferritin <100 ng/mL not associated with mortality in either group
Original publication
Summarised from the published abstract; every number is checked against it