Impact of iron deficiency on congestion and postdischarge survival in patients recently hospitalised for decompensated heart failure: a multicentre, prospective, observational analysis of the FERIC-RO study.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Open Heart Pub Date : 2025-02-27 DOI:10.1136/openhrt-2024-002851

Cornelia Margineanu, Laura Antohi, Andrew Ambrosy, Daniela Bartos, Sean Collins, Crina Sinescu, Gabriel Tatu Chitoiu, Daniel Lighezan, Dragos Vinereanu, Dana Pop, P S Pang, Javed Butler, Ovidiu Chioncel

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Abstract

Background: Iron deficiency (ID) is a highly prevalent comorbidity in patients with chronic and acute heart failure and is associated with worse clinical outcomes. We aimed to evaluate the prevalence and clinical characteristics of ID and its association with in-hospital congestion and postdischarge outcomes.

Methods: FiER deficit in Insuficienta Cardiaca in Romania was a prospective, multicentric study, enrolling 163 patients hospitalised for worsening chronic heart failure (WCHF) irrespective of left ventricular ejection fraction. ID was evaluated at discharge and defined as ferritin<100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation<20%. Patients were classified based on ID status. In-hospital changes of clinical signs of congestion and natriuretic peptides (NT-proBNP) were reported and correlated with ID status. Additionally, survival analysis at 30 and 90 days was performed and compared between patients with ID+ and ID-.

Results: The prevalence of ID was 54.6% (N=89) among 163 eligible patients. Patients with ID+ had more clinical signs of congestion and advanced New York Heart Association functional class at discharge (classes III and IV 58.4% vs 31.1%; p 0.002). NT-proBNP values at admission were higher in ID+ (9288 pg/dL vs 4414 pg/dL, p<0.001), with lower NT-proBNP decrease during hospitalisation (-45.7% vs -63.3%, p 0.003). Additionally, there was no difference in ID prevalence between discharge and 30 days after (54.6% vs 51.3%, p 0.782). Postdischarge all-cause mortality did not differ between ID+ and ID- at 30 days (5.6%% vs 2.7%, p 0.361), but at 90 days, it was higher in ID+ group (30.9% ID+ vs 9.6% ID-, p 0.005).

Conclusions: Patients hospitalised for WCHF and ID had more residual congestion, higher absolute values and significantly lower in-hospital change of NT-proBNP. A significant difference in survival between the two ID groups emerged within 90 days of hospital discharge.

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来源期刊

Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.60

自引率

3.70%

发文量

145

审稿时长

20 weeks

期刊介绍： Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.