TY - JOUR

T1 - Iron deficiency

T2 - Prevalence and relation to cardiovascular biomarkers in heart failure outpatients

AU - Schou, Morten

AU - Bosselmann, Helle

AU - Gaborit, Freja

AU - Iversen, Kasper

AU - Gøtze, Jens Peter

AU - Soletomas, Georg

AU - Rasmussen, Jon

AU - Kistorp, Caroline

AU - Kober, Lars

AU - Gustafsson, Finn

AU - Tonder, Niels

N1 - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

PY - 2015/9/15

Y1 - 2015/9/15

N2 - BACKGROUND: Both iron deficiency (ID) and cardiovascular biomarkers are associated with a poor outcome in heart failure (HF). The relationship between different cardiovascular biomarkers and ID is unknown, and the true prevalence of ID in an outpatient HF clinic is probably overlooked.OBJECTIVES: To identify the prevalence of ID in a HF clinic and evaluate whether ID is associated with increased plasma concentrations of different cardiovascular biomarkers that carry a poor prognosis.METHODS: We prospectively included 149 patients with systolic HF referred to an outpatients HF clinic. ID was defined as ferritin<100 μg/L or ferritin 100-300 μg/L and Tranferin-saturation<0.20. Five different cardiovascular biomarkers were analyzed on frozen plasma.RESULTS: The patients had a median age of 70 (Interquartile range: 64-75) years, 25% were females, 29% were in functional class III-IV and LVEF was 32 (27-39) %. The prevalence of ID was 45% (95%-confidence interval (CI): 37-53%). In multivariate analyses, ID was not associated with plasma concentrations of troponin I, NT-proBNP, MR-proANP, chromogranin A or copeptin (P>0.05 for all) but with plasma concentrations of hs-CRP (odds ratio: 2.03, 95%-CI: 1.02-4.02, P=0.043).CONCLUSION: ID is frequent in an outpatient HF clinic. ID is not associated with cardiovascular biomarkers after adjustment for traditional confounders. Inflammation, but not neurohormonal activation is associated with ID in systolic HF. Further studies are needed to understand iron metabolism in elderly HF patients.

AB - BACKGROUND: Both iron deficiency (ID) and cardiovascular biomarkers are associated with a poor outcome in heart failure (HF). The relationship between different cardiovascular biomarkers and ID is unknown, and the true prevalence of ID in an outpatient HF clinic is probably overlooked.OBJECTIVES: To identify the prevalence of ID in a HF clinic and evaluate whether ID is associated with increased plasma concentrations of different cardiovascular biomarkers that carry a poor prognosis.METHODS: We prospectively included 149 patients with systolic HF referred to an outpatients HF clinic. ID was defined as ferritin<100 μg/L or ferritin 100-300 μg/L and Tranferin-saturation<0.20. Five different cardiovascular biomarkers were analyzed on frozen plasma.RESULTS: The patients had a median age of 70 (Interquartile range: 64-75) years, 25% were females, 29% were in functional class III-IV and LVEF was 32 (27-39) %. The prevalence of ID was 45% (95%-confidence interval (CI): 37-53%). In multivariate analyses, ID was not associated with plasma concentrations of troponin I, NT-proBNP, MR-proANP, chromogranin A or copeptin (P>0.05 for all) but with plasma concentrations of hs-CRP (odds ratio: 2.03, 95%-CI: 1.02-4.02, P=0.043).CONCLUSION: ID is frequent in an outpatient HF clinic. ID is not associated with cardiovascular biomarkers after adjustment for traditional confounders. Inflammation, but not neurohormonal activation is associated with ID in systolic HF. Further studies are needed to understand iron metabolism in elderly HF patients.

KW - Aged

KW - Biomarkers

KW - C-Reactive Protein

KW - Chromogranin A

KW - Comorbidity

KW - Denmark

KW - Female

KW - Ferritins

KW - Glycopeptides

KW - Heart Failure, Systolic

KW - Humans

KW - Iron

KW - Iron Metabolism Disorders

KW - Kaplan-Meier Estimate

KW - Male

KW - Natriuretic Peptide, Brain

KW - Outpatients

KW - Peptide Fragments

KW - Prevalence

KW - Prognosis

KW - Statistics as Topic

KW - Transferrin

KW - Troponin I

U2 - 10.1016/j.ijcard.2015.05.096

DO - 10.1016/j.ijcard.2015.05.096

M3 - Journal article

C2 - 26043148

VL - 195

SP - 143

EP - 148

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -