Iron deficiency and red cell indices in patients with heart failure

摘要

Abstract Aims To investigate the prevalence of iron deficiency (ID) in heart failure (HF) patients with normal vs. abnormal red cell indices (RCI), the associations between iron parameters and RCI, and prognostic consequences of ID independently of RCI. Methods and results We analysed clinical data of 1821 patients with HF mean age 66 ± 13 years; 71 men; New York Heart Association class I/II/III/IV (11/39/44/6); left ventricular ejection fraction 45: 19. Iron deficiency (ferritin 100 μg/L or ferritin 100–299 μg/L with transferrin saturation 20) was common irrespective of the presence of anaemia (haemoglobin 12 g/dL in women and 13 g/dL in men) or low RCI, from 75 in anaemic subjects with low mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and MCH concentration (MCHC), to 36 in non‐anaemic subjects with MCV, MCH, and MCHC above the lower limit of normal. After adjustment for clinical variables, iron parameters remained independently associated with haemoglobin, MCV, MCH, MCHC, mean reticulocyte haemoglobin content (CHR), and red cell distribution width (RDW). In multivariable Cox proportional hazard regression models there was a trend towards higher mortality in patients with vs. without ID when adjusted for relevant HF prognosticators and MCH or MCHC (but not haemoglobin, CHR or RDW). Conclusions Patients with HF should be routinely screened for ID irrespective of the presence of anaemia or abnormal RCI. The detrimental impact of ID on long‐term survival in HF is partially independent of RCI.