PMID- 29580659 OWN - NLM STAT- MEDLINE DCOM- 20181108 LR - 20181108 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 261 DP - 2018 Jun 15 TI - Impact of iron deficiency on long-term clinical outcomes of hospitalized patients with heart failure. PG - 114-118 LID - S0167-5273(17)36425-2 [pii] LID - 10.1016/j.ijcard.2018.03.039 [doi] AB - BACKGROUND: Iron deficiency (ID) is commonly observed in chronic heart failure (HF) patients and is associated with worse clinical outcomes. While ID is frequent finding in hospitalized heart failure (HHF), its impact on long-term outcome in HHF patients remains unclear. METHODS: We evaluated iron status at discharge in 578 HHF patients. Absolute ID was defined as serum ferritin <100 mug/L, and functional ID (FID) was defined as serum ferritin of 100-299 mug/L with transferrin saturation <20%. The primary outcome of interest was the composite of all-cause mortality and HF admission at one year. RESULTS: Among the study population, 185 had absolute ID, 88 had FID and 305 had no evidence of ID. At one-year post-discharge, 64 patients had died and 112 had been readmitted with HF. Patients with absolute ID had more adverse events than those with FID or no ID (p = 0.021). In multivariate Cox regression analyses, absolute ID was significantly associated with increased risk of adverse events at one year (HR 1.50, 95% CI 1.02-2.21, p = 0.040) compared with the remaining patients. Sensitivity analysis revealed that its prognostic effect did not differ across anemic status, or between HF with reduced and preserved ejection fraction (p for interaction = 0.17, 0.68, respectively). CONCLUSION: Absolute ID, but not FID, at discharge was associated with increased risk of one-year mortality or HF admission in patients with HHF. Further studies are required to evaluate the role of repleting iron stores and its impact on clinical outcomes in patients with HHF. CI - Copyright (c) 2018 Elsevier B.V. All rights reserved. FAU - Nakano, Hiroki AU - Nakano H AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Cardiology, Tokyo Medical University, Tokyo, Japan. FAU - Nagai, Toshiyuki AU - Nagai T AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; National Heart & Lung Institute, Imperial College London, London, United Kingdom; Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address: tnagai@huhp.hokudai.ac.jp. FAU - Sundaram, Varun AU - Sundaram V AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; National Heart & Lung Institute, Imperial College London, London, United Kingdom; Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA; Royal Brompton Hospital, London, United Kingdom; Harefield Hospital, London, United Kingdom. FAU - Nakai, Michikazu AU - Nakai M AD - Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Nishimura, Kunihiro AU - Nishimura K AD - Preventive Medicine and Epidemiology Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Honda, Yasuyuki AU - Honda Y AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Honda, Satoshi AU - Honda S AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Iwakami, Naotsugu AU - Iwakami N AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Sugano, Yasuo AU - Sugano Y AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Asaumi, Yasuhide AU - Asaumi Y AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Aiba, Takeshi AU - Aiba T AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Noguchi, Teruo AU - Noguchi T AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Kusano, Kengo AU - Kusano K AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Yokoyama, Hiroyuki AU - Yokoyama H AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Ogawa, Hisao AU - Ogawa H AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Yasuda, Satoshi AU - Yasuda S AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Chikamori, Taishiro AU - Chikamori T AD - Department of Cardiology, Tokyo Medical University, Tokyo, Japan. FAU - Anzai, Toshihisa AU - Anzai T AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. CN - NaDEF investigators LA - eng PT - Journal Article PT - Observational Study DEP - 20180311 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Transferrin) RN - 9007-73-2 (Ferritins) SB - IM MH - Aged MH - Aged, 80 and over MH - Anemia, Iron-Deficiency/*blood/diagnosis/*mortality MH - Cohort Studies MH - Female MH - Ferritins/blood MH - Follow-Up Studies MH - Heart Failure/*blood/diagnosis/*mortality MH - Hospitalization/*trends MH - Humans MH - Male MH - Prospective Studies MH - Registries MH - Time Factors MH - Transferrin/metabolism MH - Treatment Outcome OTO - NOTNLM OT - Hospitalized heart failure OT - Iron deficiency OT - Prognosis EDAT- 2018/03/28 06:00 MHDA- 2018/11/09 06:00 CRDT- 2018/03/28 06:00 PHST- 2017/10/17 00:00 [received] PHST- 2018/02/04 00:00 [revised] PHST- 2018/03/09 00:00 [accepted] PHST- 2018/03/28 06:00 [pubmed] PHST- 2018/11/09 06:00 [medline] PHST- 2018/03/28 06:00 [entrez] AID - S0167-5273(17)36425-2 [pii] AID - 10.1016/j.ijcard.2018.03.039 [doi] PST - ppublish SO - Int J Cardiol. 2018 Jun 15;261:114-118. doi: 10.1016/j.ijcard.2018.03.039. Epub 2018 Mar 11.