Abstract 12207: Delinking Iron Deficiency From Anemia in Systolic Heart Failure: Prevalence and Correlation With Severity

• Published in: Circulation (New York, N.Y.) Vol. 138; no. Suppl_1 Suppl 1; p. A12207
• Main Authors: Ambesh, Paurush, Kazmi, Danish, Kapoor, Aditya, Sinha, Archana, Kashyap, Shridhar, Khanna, Roopali, Kumar, Sudeep, Garg, Naveen, Tewari, Satyendra, Goel, Praveen K
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 06.11.2018
• ISSN: 0009-7322; 1524-4539

Abstract Category11.51-Heart FailureDisease management, Quality of Care and Clinical outcomes.TitleDelinking Iron deficiency from Anemia in Systolic Heart failurePrevalence and correlation with severity.IntroductionIron deficiency (ID) has been reported in patients with heart failure (HF) and is associated with sympathetic activation, ventricular hypertrophy/dilatation and pro-inflammatory cytokine release. Iron deficiency can occur in chronic HF even in non-anemic patients since anemia only becomes apparent when the total body iron stores get sufficiently depleted.HypothesisWe assessed the hypothesis, that ID existed in both anemic and non-anemic systolic HF patients and it correlated with HF severity.MethodsHemoglobin, Serum Iron, Red Cell indices, Total Iron Binding Capacity (TIBC), Ferritin and BNP were assessed in chronic systolic HF patients (n=100, NYHA Class II-III, LVEF < 45%) and 50 matched controls. Absolute ID was defined as serum ferritin < 100 mcg/L and functional ID as serum ferritin 100-299 mcg/L with Transferrin Saturation (TSAT < 20%).ResultsPatients with HF (age 52+13 yrs, LVEF 29.4±9.3%) had significantly lower Hemoglobin (11.77±1.8 vs 13.8±0.8 g/dl), MCV (88.5±7.5 vs 95.4±3.2 fl) and MCHC (30.9±1.9 vs 34.9±1.5 g/dl). Parameters of iron metabolism viz. serum iron (61.5±27.7 vs 118.6±41.4 mcg/dl), TSAT (20.3±9.7 vs 36.4±11.4 %), serum ferritin(156.7±133.6 vs 240.6±124.8 mcg/l) were significantly lower while TIBC was higher in those with HF (322.0+/-96.4 vs 290.7+/-46.8 mcg/dl), all p<0.01. Overall, 67% of HF patients had anemia. The prevalence of absolute and functional ID was noted in 44%, 44.8%, 42.4% and 20%, 19.4%, 21.2% of all HF, anemic and non-anemic HF patients respectively. Anemia of chronic disease (ACD), pure iron deficiency anemia (IDA) and ACD + IDA were observed in 41.8%, 8.9% and 7.5% respectively. Higher NYHA class (r=0.2, p=0.02) and higher BNP levels (r=0.2, p=0.04) independently correlated with impaired circulating iron pool (TSAT < 20%) and stored iron (serum ferritin).ConclusionsIron Deficiency is prevalent in nearly two-thirds of systolic heart failure patients, irrespective of their anemic status. Moreover, iron stores correlate with HF severity.