PMID- 26705670 OWN - NLM STAT- MEDLINE DCOM- 20161013 LR - 20170903 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 205 DP - 2016 Feb 15 TI - The impact of iron deficiency and anaemia on exercise capacity and outcomes in patients with chronic heart failure. Results from the Studies Investigating Co-morbidities Aggravating Heart Failure. PG - 6-12 LID - S0167-5273(15)30987-6 [pii] LID - 10.1016/j.ijcard.2015.11.178 [doi] AB - Anaemia and iron deficiency (ID) are important co-morbidities in patients with chronic heart failure (HF) and both may lead to reduced exercise capacity. METHODS: We enrolled 331 out-patients with stable chronic HF (mean age: 64 +/- 11 years, 17% female, left ventricular ejection fraction [LVEF] 35 +/- 13%, body mass index [BMI] 28.5 +/- 5.2 kg/m(2), New York Heart Association [NYHA] class 2.2 +/- 0.7, chronic kidney disease 35%, glomerular filtration rate 61.7 +/- 20.1 mL/min). Anaemia was defined according to World Health Organization criteria (haemoglobin [Hb] < 13 g/dL in men, < 12 g/dL in women). ID was defined as serum ferritin < 100 mug/L or ferritin < 300 mug/L with transferrin saturation (TSAT) < 20%. Exercise capacity was assessed as peak oxygen consumption (peak VO2) by spiroergometry and 6-minute walk test (6MWT). RESULTS: A total of 91 (27%) patients died from any cause during a mean follow-up of 18 months. At baseline, 98 (30%) patients presented with anaemia and 149 (45%) patients presented with ID. We observed a significant reduction in exercise capacity in parallel to decreasing Hb levels (r = 0.24, p < 0.001). In patients with anaemia and ID (n = 63, 19%), exercise capacity was significantly lower than in patients with ID or anaemia only. Cox regression analysis showed that after adjusting for NYHA, age, hsCRP and creatinine anaemia is an independent predictor of mortality in patients with HF (hazard ratio [HR]: 0.56, 95% confidence interval [CI]: 0.33-0.97, p = 0.04). CONCLUSION: The impact of anaemia on reduced exercise capacity and on mortality is stronger than that of ID. Anaemia remained an independent predictor of death after adjusting for clinically relevant variables. CI - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved. FAU - Ebner, Nicole AU - Ebner N AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany; Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Jankowska, Ewa A AU - Jankowska EA AD - Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Poland. FAU - Ponikowski, Piotr AU - Ponikowski P AD - Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Poland. FAU - Lainscak, Mitja AU - Lainscak M AD - Department of Cardiology, General Hospital Celje, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. FAU - Elsner, Sebastian AU - Elsner S AD - Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Sliziuk, Veronika AU - Sliziuk V AD - Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Steinbeck, Lisa AU - Steinbeck L AD - Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Kube, Jennifer AU - Kube J AD - Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Bekfani, Tarek AU - Bekfani T AD - Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Scherbakov, Nadja AU - Scherbakov N AD - Center for Stroke Research Berlin, Charite University Medical School, Germany. FAU - Valentova, Miroslava AU - Valentova M AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany; 1st Department of Internal Medicine, Comenius University, Bratislava, Slovak Republic. FAU - Sandek, Anja AU - Sandek A AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany; Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - Doehner, Wolfram AU - Doehner W AD - Center for Stroke Research Berlin, Charite University Medical School, Germany. FAU - Springer, Jochen AU - Springer J AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany. FAU - Anker, Stefan D AU - Anker SD AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany; Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. FAU - von Haehling, Stephan AU - von Haehling S AD - Innovative Clinical Trials, Department of Cardiology and Pneumology, University of Medicine Gottingen, Germany; Applied Cachexia Research, Department of Cardiology, Charite-University Medical School, Campus Virchow-Klinikum Berlin, Germany. Electronic address: stephan.von.haehling@web.de. LA - eng PT - Journal Article DEP - 20151202 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2016 May 1;210:179. PMID: 26944515 MH - Adult MH - Aged MH - Aged, 80 and over MH - Anemia, Iron-Deficiency/*blood/diagnosis/*mortality MH - Chronic Disease MH - Cohort Studies MH - Comorbidity MH - Exercise Tolerance/*physiology MH - Female MH - Follow-Up Studies MH - Heart Failure/*blood/diagnosis/*mortality MH - Humans MH - Male MH - Middle Aged MH - Survival Rate/trends MH - Treatment Outcome OTO - NOTNLM OT - Anaemia OT - Exercise capacity OT - Heart failure OT - Iron deficiency EDAT- 2015/12/27 06:00 MHDA- 2016/10/14 06:00 CRDT- 2015/12/27 06:00 PHST- 2015/09/10 00:00 [received] PHST- 2015/11/25 00:00 [revised] PHST- 2015/11/27 00:00 [accepted] PHST- 2015/12/27 06:00 [entrez] PHST- 2015/12/27 06:00 [pubmed] PHST- 2016/10/14 06:00 [medline] AID - S0167-5273(15)30987-6 [pii] AID - 10.1016/j.ijcard.2015.11.178 [doi] PST - ppublish SO - Int J Cardiol. 2016 Feb 15;205:6-12. doi: 10.1016/j.ijcard.2015.11.178. Epub 2015 Dec 2.