Patricia Palau1, Pau Llàcer2, Eloy Domínguez3, Juan Pablo Tormo3, Rim Zakarne3, Anna Mollar1, Ana Martínez1, Gema Miñana1, Enrique Santas1, Luis Almenar4, Lorenzo Fácila5, Rafael De La Espriella1, Eduardo Núñez1, Luis Manzano2, Antoni Bayés-Genís6,7, Julio Núñez8,9. 1. Servicio de Cardiología, Hospital Clínico Universitario. INCLIVA. Universitat de València, Valencia, Spain. 2. Servicio de Medicina Interna. Hospital Universitario Ramón Y Cajal, Madrid, Spain. 3. FISABIO, Universitat Jaume I, Castellón, Spain. 4. Servicio de Cardiología, Hospital La Fe. Universitat de València, Valencia, Spain. 5. Servicio de Cardiología, Hospital General Universitario de Valencia. Universitat de València, Valencia, Spain. 6. Institut del Cor, Hospital Universitari Germans Trias I Pujol, Badalona. Universitat Autònoma de Barcelona, Badalona, Spain. 7. CIBER Cardiovascular, Madrid, Spain. 8. Servicio de Cardiología, Hospital Clínico Universitario. INCLIVA. Universitat de València, Valencia, Spain. yulnunez@gmail.com. 9. CIBER Cardiovascular, Madrid, Spain. yulnunez@gmail.com.
Abstract
BACKGROUND: For patients with heart failure (HF), iron deficiency (ID) is a common therapeutic target. However, little is known about the utility of transferrin saturation (TSAT) or serum ferritin for risk stratification in decompensated HF (DHF) or the European Society of Cardiology's (ESC) current definition of ID (ferritin < 100 μg/L or TSAT < 20% if ferritin is 100-299 μg/L). We evaluated the association between these potential markers of ID and the risk of 30-day readmission for HF or death in patients with DHF. METHODS: We retrospectively included 1701 patients from a multicenter registry of DHF. Serum ferritin and TSAT were evaluated 24-72 h after hospital admission, and multivariable Cox regression was used to assess their association with the composite endpoint. RESULTS: Participants' median (quartiles) age was 76 (68-82) years, 43.8% were women, and 51.7% had a left ventricular ejection fraction > 50%. Medians for NT-proBNP, TSAT, and ferritin were 4067 pg/mL (1900-8764), 14.1% (9.0-20.3), and 103 ug/L (54-202), respectively. According to the current ESC definition, 1,246 (73.3%) patients had ID. By day 30, there were 177 (10.4%) events (95 deaths and 85 HF readmission). After multivariable adjustment, lower TSAT was associated with outcome (p = 0.009) but serum ferritin was not (HR 1.00; 95% confidence interval 0.99-1.00, p = 0.347). CONCLUSIONS: Lower TSAT, but not ferritin, was associated with a higher risk of short-term events in patients with DHF. Further research is needed to confirm these findings and the utility of serum ferritin as a marker of ID in DHF.
BACKGROUND: For patients with heart failure (HF), iron deficiency (ID) is a common therapeutic target. However, little is known about the utility of transferrin saturation (TSAT) or serum ferritin for risk stratification in decompensated HF (DHF) or the European Society of Cardiology's (ESC) current definition of ID (ferritin < 100 μg/L or TSAT < 20% if ferritin is 100-299 μg/L). We evaluated the association between these potential markers of ID and the risk of 30-day readmission for HF or death in patients with DHF. METHODS: We retrospectively included 1701 patients from a multicenter registry of DHF. Serum ferritin and TSAT were evaluated 24-72 h after hospital admission, and multivariable Cox regression was used to assess their association with the composite endpoint. RESULTS: Participants' median (quartiles) age was 76 (68-82) years, 43.8% were women, and 51.7% had a left ventricular ejection fraction > 50%. Medians for NT-proBNP, TSAT, and ferritin were 4067 pg/mL (1900-8764), 14.1% (9.0-20.3), and 103 ug/L (54-202), respectively. According to the current ESC definition, 1,246 (73.3%) patients had ID. By day 30, there were 177 (10.4%) events (95 deaths and 85 HF readmission). After multivariable adjustment, lower TSAT was associated with outcome (p = 0.009) but serum ferritin was not (HR 1.00; 95% confidence interval 0.99-1.00, p = 0.347). CONCLUSIONS: Lower TSAT, but not ferritin, was associated with a higher risk of short-term events in patients with DHF. Further research is needed to confirm these findings and the utility of serum ferritin as a marker of ID in DHF.
Authors: Julio Núñez; Gema Miñana; Ingrid Cardells; Patricia Palau; Pau Llàcer; Lorenzo Fácila; Luis Almenar; Maria P López-Lereu; Jose V Monmeneu; Martina Amiguet; Jessika González; Alicia Serrano; Vicente Montagud; Raquel López-Vilella; Ernesto Valero; Sergio García-Blas; Vicent Bodí; Rafael de la Espriella-Juan; Josep Lupón; Jorge Navarro; José Luis Górriz; Juan Sanchis; Francisco J Chorro; Josep Comín-Colet; Antoni Bayés-Genís Journal: J Am Heart Assoc Date: 2020-02-13 Impact factor: 5.501
Authors: Ridha I S Alnuwaysir; Martijn F Hoes; Dirk J van Veldhuisen; Peter van der Meer; Niels Grote Beverborg Journal: J Clin Med Date: 2021-12-27 Impact factor: 4.964
Authors: Gema Miñana; Miguel Lorenzo; Antonio Ramirez de Arellano; Sandra Wächter; Rafael de la Espriella; Clara Sastre; Anna Mollar; Eduardo Núñez; Vicent Bodí; Juan Sanchis; Antoni Bayés-Genís; Julio Núñez Journal: J Clin Med Date: 2022-05-02 Impact factor: 4.241