Iron deficiency in Taiwanese patients with heart failure and reduced ejection fraction

Abstract

Background: Iron deficiency (ID) is a common comorbidity among patients with heart failure and reduced ejection fraction (HFrEF), and is associated with poorer outcomes independent of anemia. This study aimed to evaluate the prevalence and prognostic significance of ID in Taiwanese patients with HFrEF. Methods: We included HFrEF patients from two multicenter cohorts at different periods. The multivariate Cox regression analysis was applied to assess the risk of outcomes associated with ID, accounting for the varying risk of death. Results: Of the 3612 patients with HFrEF registered from 2013 to 2018, 665 patients (18.4%) had available baseline iron profile measurements. Of these, 290 patients (43.6%) were iron deficient; 20.2% had ID+/anemia+, 23.4% ID+/anemia−, 21.5% ID−/anemia+, and 34.9% ID−/anemia−. Regardless of anemia status, patients with coexisting ID had a higher risk than those without ID (all-cause mortality: 14.3 vs 9.5 per 100 patient-years, adjusted hazard ratio [HR] 1.33; 95% confidence interval [CI], 0.96-1.85; p = 0.091; cardiovascular mortality: 10.5 per 100 patient-years vs 6.1, adjusted HR 1.54 [95% CI, 1.03-2.30; p = 0.037]; cardiovascular mortality or first unplanned hospitalization for HF: 36.7 vs 19.7 per 100 patient-years, adjusted HR 1.57 [95% CI, 1.22-2.01; p < 0.001]). Among patients eligible for treatment in the IRONMAN trial design (43.9%), parenteral iron therapy was estimated to reduce heart failure hospitalizations and cardiovascular deaths by 13.7 per 100 patient-years. Conclusion: Iron profiles were tested in less than one-fifth of the Taiwanese HFrEF cohort. ID was present in 43.6% of tested patients and was independently associated with poor prognosis in these patients.

Cardiovascular Comorbidities in COVID-19: Comprehensive Analysis of Key Topics

“…Our results show that the term iron metabolism disorder occurs significantly more frequently in COVID-19 articles related to heart failure than in CVD articles on the same topic. Interestingly, iron deficiency (ID) is frequently observed in patients with heart failure [61][62][63]. Furthermore, ID correlates with an increased incidence of right ventricular failure in patients with acute HF [64,65].…”

Killing two birds with one stone: The potential of iron supplementation in Chinese HFrEF patients

“…We read with interest the study by Sung et al, 1 which aimed to assess the prevalence and significance of iron deficiency (ID) in Taiwanese patients with heart failure and reduced ejection fraction (HFrEF). Among the 3612 included HFrEF patients, 43.6% were found to have ID, irrespective of their anemia status.…”