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Introduction: Iron deficiency (ID) is a common comorbidity in chronic heart failure patients that can be routinely diagnosed by serum laboratorial tests showing reduced ferritin and/or transferrin saturation (TSAT) levels. However, it is not clear the impact on survival of different biochemical tests widely used for ID diagnosis. Hypothesis: We hypothesized that different laboratorial tests for ID diagnosis also implies in different prognostic values in heart failure patients. Methods: We performed a cohort study with 108 chronic and stable heart failure patients, attended in an outpatient clinic. The mean age was 59 ± 14 years, 53% were male, 31% had Chagas Disease, and 35% were NYHA functional class III/IV. The mean follow-up time was 712 ± 277 days, and the primary endponint investigated was all-cause death. We analysed biochemical levels of ferritin, serum iron, and latent iron binding capacity, which were used to estimate TSAT. Cut-off values for serum ferritin was <100 ng/dL and TSAT <20%. Combined values of ferritin and TSAT determined three metabolic states: iron depleted stores (ferritin <100 ng/dL with TSAT >20%), functional iron deficiency (TSAT <20% ferritin >100 ng/dL), and absolute iron deficiency (ferritin <100 ng/dL to TSAT <20%). Results: During the study, 31 (28.7%) deaths were reported. A univariate analysis showed a higher mortality rate in patients with serum sodium <130 mmol/L (P < .001), advanced NYHA functional class (III/IV) (P < .05), systolic blood pressure <90 mmHg (P < .01), and creatinine clearance <60 mL/min (P < .01). In the univariate analysis for ID assessments, only TSAT <20% was associated with poor survival (P < .01). On metabolic iron states investigation, functional (P < .05) and absolute iron deficiency (P < .01) were associated with worse prognosis. In a multivariate model TSAT <20% (HR 2.15 -P < .005) and functional iron deficiency (TSAT <20% with ferritin >100 ng/dL) (P < .005; HR 1.81) remained independent prognostic factors. Iron depleted stores, diagnosed solely by ferritin <100 ng/dL, had no correlation with survival. Conclusions: Iron deficiency, diagnosed when TSAT parameter <20%, identified heart failure patients with higher mortality, independent of ferritin values.

Introduction Though venous thromboembolism (VTE) is thought to be under-diagnosed, roughly 900,000 people are estimated to be affected by VTE each year in the U.S. According to CDC figures, VTE accounts for roughly 60,000 to 100,000 annual deaths. Recent research has demonstrated that the risk of mortality in patients with pulmonary embolism (PE) who were found to have concomitant deep vein thrombosis (DVT) was higher in comparison to patients with PE who did not have concomitant DVT (Beccatini et al. Chest 2015). We have sought to evaluate the risk of concomitant DVT among patients diagnosed with PE in our hospital population. Methods This is an ongoing retrospective cohort study examining the incidence of PE with concomitant DVT among patients admitted to an urban community teaching hospital between January 2011 and March 2015. Radiological findings for patients who underwent computed tomography angiography (CTA) and venous duplex ultrasound were reviewed. Patients found to have PE were sub-divided into two groups: those with concomitant DVT and those without concomitant DVT. Mortality risk, correlation with inferior vena cava (IVC) filter placement, and association with other comorbidities continue to be evaluated. Results Results of 1,777 CTAs were reviewed of which 160 demonstrated a positive finding of PE: 103 women (64.4%) and 57 men (35.6%). Patient age ranged from 19 to 97 years old. The mean and median ages for all PE-positive patients were 61.9 and 63,respectively. Several patients demonstrated multiple emboli; to wit, 273 distinct PEs were noted among the 160 individual patients. Of the 160 patients with PE, 81 were found to have concomitant DVT (50.6%). Discussion The combination of high mortality and rapid-though often overlooked-onset make VTE a uniquely vexing condition. Though the nature of the relationship between DVT and the increased mortality risk among patients with PE is unclear, the correlation has been convincingly demonstrated by prior research and may signal the need for more aggressive management for patients with concomitant thromboemboli. Our findings, consistent with the literature, suggest that the prevalence of concomitant PE and DVT may be substantial in the hospitalized population. Disclosures No relevant conflicts of interest to declare.