Lars H Lund1,2, Gianluigi Savarese1,2, Peter Moritz Becher1,3,4, Benedikt Schrage1,3,4, Lina Benson1, Marat Fudim5,6, Carin Corovic Cabrera7,8, Ulf Dahlström9, Giuseppe M C Rosano10,11, Ewa A Jankowska12, Stefan D Anker13. 1. Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 2. Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden. 3. Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany. 4. German Center of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Berlin, Germany. 5. Department of Medicine, Duke University Medical Center, Durham, NC, USA. 6. Duke Clinical Research Institute, Durham, NC, USA. 7. Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. 8. Department of Cardiology, Södersjukhuset, Stockholm, Sweden. 9. Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. 10. St George's Hospital Medical School, London, UK. 11. IRCCS San Raffaele Roma, Rome, Italy. 12. Department of Heart Diseases, Wroclaw Medical University, and Centre for Heart Diseases, University Hospital, Wroclaw, Poland. 13. Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Berlin, Germany.
Abstract
AIMS: Iron deficiency (ID) is associated with poor prognosis regardless of anaemia. Intravenous iron improves quality of life and outcomes in patients with ID and heart failure (HF) with reduced ejection fraction (HFrEF). In the Swedish HF registry, we assessed (i) frequency and predictors of ID testing; (ii) prevalence and outcomes of ID with/without anaemia; (iii) use of ferric carboxymaltose (FCM) and its predictors in patients with ID. METHODS AND RESULTS: We used multivariable logistic regressions to assess patient characteristics independently associated with ID testing/FCM use, and Cox regressions to assess risk of outcomes associated with ID. Of 21 496 patients with HF and any ejection fraction enrolled in 2017-2018, ID testing was performed in 27%. Of these, 49% had ID and more specifically 36% had ID-/anaemia-, 15% ID-/anaemia+, 29% ID+/anaemia-, and 20% ID+/anaemia+ (48%, 39%, 13%, 30% and 18% in HFrEF, respectively). Risk of recurrent all-cause hospitalizations was higher in patients with ID regardless of anaemia. Of 1959 patients with ID, 19% received FCM (24% in HFrEF). Important independent predictors of ID testing and FCM use were anaemia, higher New York Heart Association class, having HFrEF, and referral to HF specialty care. CONCLUSION: In this nationwide HF registry, ID testing occurred in only about a quarter of the patients. Among tested patients, ID was present in one half, but only one in five patients received FCM indicating low adherence to current guidelines on screening and treatment.
AIMS: Iron deficiency (ID) is associated with poor prognosis regardless of anaemia. Intravenous iron improves quality of life and outcomes in patients with ID and heart failure (HF) with reduced ejection fraction (HFrEF). In the Swedish HF registry, we assessed (i) frequency and predictors of ID testing; (ii) prevalence and outcomes of ID with/without anaemia; (iii) use of ferric carboxymaltose (FCM) and its predictors in patients with ID. METHODS AND RESULTS: We used multivariable logistic regressions to assess patient characteristics independently associated with ID testing/FCM use, and Cox regressions to assess risk of outcomes associated with ID. Of 21 496 patients with HF and any ejection fraction enrolled in 2017-2018, ID testing was performed in 27%. Of these, 49% had ID and more specifically 36% had ID-/anaemia-, 15% ID-/anaemia+, 29% ID+/anaemia-, and 20% ID+/anaemia+ (48%, 39%, 13%, 30% and 18% in HFrEF, respectively). Risk of recurrent all-cause hospitalizations was higher in patients with ID regardless of anaemia. Of 1959 patients with ID, 19% received FCM (24% in HFrEF). Important independent predictors of ID testing and FCM use were anaemia, higher New York Heart Association class, having HFrEF, and referral to HF specialty care. CONCLUSION: In this nationwide HF registry, ID testing occurred in only about a quarter of the patients. Among tested patients, ID was present in one half, but only one in five patients received FCM indicating low adherence to current guidelines on screening and treatment.
Authors: Andrew Sindone; Wolfram Doehner; Nicolas Manito; Theresa McDonagh; Alain Cohen-Solal; Thibaud Damy; Julio Núñez; Otmar Pfister; Peter van der Meer; Josep Comin-Colet Journal: J Clin Med Date: 2022-05-25 Impact factor: 4.964
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
Authors: Kieran F Docherty; Paul Welsh; Subodh Verma; Rudolf A De Boer; Eileen O'Meara; Olof Bengtsson; Lars Køber; Mikhail N Kosiborod; Ann Hammarstedt; Anna Maria Langkilde; Daniel Lindholm; Dustin J Little; Mikaela Sjöstrand; Felipe A Martinez; Piotr Ponikowski; Marc S Sabatine; David A Morrow; Morten Schou; Scott D Solomon; Naveed Sattar; Pardeep S Jhund; John J V McMurray Journal: Circulation Date: 2022-08-16 Impact factor: 39.918