Disordered Iron Homeostasis Among Nigerians with Chronic Heart Failure

Abstract

Background: Iron deficiency (ID) often coexists with heart failure and has recently become a therapeutic option in its management. Multiple markers are often required to adequately estimate iron status. This study was aimed at describing the status of iron homeostasis among heart failure patients in Nigeria. Materials and Methods: This was a cross-sectional study done at two tertiary centers in Nigeria. One hundred and forty patients with a diagnosis of heart failure were recruited into the study. Full blood count, total serum iron, total iron-binding capacity, and serum ferritin were measured. Anemia was defined by standardized criteria. Data analysis was done with SPSS 20.0. Results: The mean age of the study patients was 62.96 ± 16.34 years. Disordered iron homeostasis was common, often characterized by predominantly low total serum iron and low transferrin saturation in the presence of normal or high serum ferritin. ID was reported in 60.0% of all patients including 61.3% of anemic and 51.9% of nonanemic patients, P = not significant. High ferritin level was documented in fifty (35.7%) patients (36.8% anemic vs. 32.4% nonanemic patients, P = 0.40). Pulmonary hypertension was more frequent among anemic patients found in 45 patients (including 42.5% of anemic vs. 8.8% of nonanemic patients). ID was associated with poor functional status including ejection fraction, deranged renal function, and advanced disease. Conclusion: Functional ID is very common among heart failure patients in Nigeria irrespective of their anemia status. It is associated with poor functional status and may be a potential therapeutic strategy in Africans with heart failure.

Atrial Fibrillation in Heart Failure: Epidemiology, Quality of Life and Clinical Characteristics in the Iron Deficiency and ANaemia in Heart Failure (IDAN-HF) Study in Ogbomoso, Nigeria

“…Other authors have also suggested that AF is more prevalent among men than women (34). This study however found no association of gender with AF in HF subjects, contrary to other reports that have reported such a link (11,14). This may be related to regional variation and relatively small sample size among others.…”

“…The patients were recruited over six months. The full details of the methodology for the Iron Deficiency and ANaemia in Heart Failure (IDAN-HF) study have been published elsewhere (11). The clinical data and other information of enrolled participants were recorded with a data collection form.…”

“…AF among Africans is more likely to be valvular AF due to a high burden of rheumatic and infective valvular heart diseases (8)(9)(10). Some authors have shown that AF is associated with advanced HF and certain other clinical characteristics, including age, gender, and HF phenotype, among others (11,12).…”

“…There is a complex interplay between HF and AF. HF can precipitate AF, and AF can also lead to HF (5,11,(13)(14)(15)(16). The impact of AF in HF subjects should therefore be of major interest among Africans due to the variability in the aetiology of AF between Africans and Caucasians.…”

Management of Iron Deficiency in Heart Failure: A Review of Evidence

“…Sixteen studies evaluated IV iron, although agents, doses, and frequencies ranged widely. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”