Iron deficiency in heart failure

Dinatolo, Elisabetta; Dasseni, Nicolò; Metra, Marco; Lombardi, Carlo; Haehling, Stephan von

doi:10.2459/jcm.0000000000000686

Cited by 6 publications

(8 citation statements)

References 83 publications

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“…The reason for the influence of haemoglobin on mortality has to be sought in the reduced oxygen-carrying capacity of blood that brings to increased cardiac work, elevated demand-related ischaemia, and renal hypoxia. 37 Moreover, our multivariable analysis did not point high non-sensitive TnI levels and hyponatremia as independent predictors of mortality, in contrast to several studies. [38][39][40][41][42][43] Finally, we found that an EF <40% was the only predictor of both all-cause mortality and CV mortality at the multivariable analysis.…”

Section: Predictors Of Outcomescontrasting

confidence: 98%

In‐hospital and long‐term mortality for acute heart failure: analysis at the time of admission to the emergency department

et al. 2020

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Aims Acute heart failure (AHF) leads to a drastic increase in mortality and rehospitalization. The aim of the study was to identify prognostic variables in a real-life population of AHF patients admitted to the emergency department with acute shortness of breath. Methods and results We evaluated potential predictors of mortality in 728 consecutive patients admitted to the emergency department with AHF. Possible predictors of all-cause and cardiovascular (CV) mortality were investigated by Cox and Fine and Gray models at multivariable analysis. Among the 728 patients, 256 died during the entire follow-up, 142 of these due to CV cause. The 1 year mortality rate was 20%, with the highest risk of death during the index hospitalization (with 8% estimate in-hospital mortality at 30 days). A higher risk of events during the index hospitalization was more evident for the CV deaths, for which we found a cumulative 1 year incidence of 12% with a cumulative incidence in the first 30 days of hospitalization of about 5%. At multivariable analysis, age (P < 0.001), New York Heart Association (NYHA) class IV vs. I-II-III (P = 0.001), systolic blood pressure (P < 0.001), non-cardiac co-morbidities (≥3 vs. 0, P = 0.05), oxygen saturation (P = 0.03), serum creatinine (P < 0.001), and left ventricular ejection fraction (LVEF) (40-49% vs. <40%, P = 0.004; ≥50% vs. <40%, P = 0.003) were independent predictors of all-cause mortality during the entire follow-up. Age (P = 0.03), systolic blood pressure (P = 0.01), oxygen saturation (P = 0.03), serum creatinine (P = 0.02), and LVEF (40-49% vs. <40%, P = 0.03; ≥50% vs. <40%, P = 0.004) were independent predictors of CV mortality during the entire follow-up. NYHA class IV vs. I-II-III (P < 0.001), serum creatinine (P = 0.01), and LVEF (40-49% vs. <40%, P = 0.02; ≥50% vs. <40%, P < 0.001) remained independent predictors for in-hospital death, while only serum creatinine (P = 0.04), LVEF (40-49% vs. <40%: 0.32, P = 0.04; ≥50% vs. <40%, P < 0.001), and NYHA class vs. I-II-III (P = 0.02) remained predictors for in-hospital CV mortality. Conclusions In this real-life cohort of patients with AHF, the results showed a similar mortality rate comparing with other analysis and with the most important registries. Age, NYHA class IV, systolic blood pressure, creatinine levels, sodium levels, and ejection fraction were independent predictors of 1 year mortality, while LVEF <40% was the only predictor of both all-cause mortality and CV mortality.

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Section: Predictors Of Outcomescontrasting

confidence: 98%

In‐hospital and long‐term mortality for acute heart failure: analysis at the time of admission to the emergency department

et al. 2020

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“…However, in a recent analysis of the MECKI score database 27 performed in 3927 HFrEF patients, a worse prognosis was observed in patients with poor glycaemic control (HbA1c >8%) (Figure 1), whereas the presence of a diabetic status and ongoing anti-diabetic treatment were not related to prognosis after correction for multiple confounders. 8 Left ventricular (LV) dysfunction in patients with type 2 diabetes may present as HFpEF, HFrEF or heart failure with mid-range ejection fraction. LV diastolic dysfunction is frequent in both pre-diabetes and overt diabetes, and its severity correlates with insulin resistance and the degree of glucose dysregulation.…”

Section: Diabetesmentioning

confidence: 99%

“…7 As already discussed for anaemia, also iron deficiency, alone or combined with an anaemic status, is responsible for reduced exercise tolerance, affects quality of life and results in higher rates of hospitalizations and death in heart failure patients. 8 As regards exercise intolerance, Jankowska et al. 9 reported in 443 chronic heart failure patients the independent role of iron deficiency in determining reduced exercise capacity.…”

Section: Anaemia and Iron Deficiencymentioning

confidence: 99%

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Role of comorbidities in heart failure prognosis Part I: Anaemia, iron deficiency, diabetes, atrial fibrillation

Paolillo¹,

Scardovi

Campodonico

2020

European Journal of Preventive Cardiology

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Cardiovascular and non-cardiovascular comorbidities are frequently observed in heart failure patients, complicating the therapeutic management and leading to poor prognosis. The prompt recognition of associated comorbid conditions is of great importance to optimize the clinical management, the follow-up, and the treatment of patients affected by chronic heart failure. Anaemia and iron deficiency are commonly reported in all heart failure forms, have a multifactorial aetiology and are responsible for reduced exercise tolerance, impaired quality of life, and poor long-term prognosis. Diabetes mellitus is highly prevalent in heart failure and a poor glycaemic control is associated with worst outcome. Two specific heart failure forms are usually observed in diabetic patients: an ischaemic cardiomyopathy or a typical diabetic cardiomyopathy. The implementation of use of sodium-glucose cotransporter-2 inhibitors will much improve in the near future the long-term prognosis of patients affected by heart failure and diabetes. Among cardiovascular comorbidities, atrial fibrillation is the most common arrhythmic disease of heart failure patients and it is still not clear whether its presence should be considered as a prognostic indicator or as a marker of advanced disease. The aim of the present review was to explore the clinical and prognostic impact of anaemia and iron deficiency, diabetes mellitus, and atrial fibrillation in patients affected by chronic heart failure.

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“…Iron deficiency affects up to 50% of heart failure patients and has been associated with poor quality of life, impaired exercise tolerance, and increased mortality [7]. The case presented here shows that intravenous iron supplementation not only rendered the patient operable with respect to his recently detected colon carcinoma, but also effectively improved the cardiac symptoms he had been assessed for in the first place.…”

Section: Discussionmentioning

confidence: 78%

Resolution of Cardiac Symptoms through Preoperative Intravenous Iron Supplementation in a Cancer Patient

Nawratil¹,

Berger²,

Geisberger³

2019

CRCM

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Cardiologic assessment was conducted on a 78-year-old male patient scheduled for elective aortic valve surgery who complained of angina and dyspnea that had arisen over the previous few months. Evaluation showed stable coronary artery disease and iron deficiency anemia (hemoglobin, 7.7 g/dL). Colonoscopy revealed a non-stenosing carcinoma of the right colonic flexure that was causing chronic blood loss. The interdisciplinary tumor board of the hospital decided that his need for an extended right hemicolectomy followed by resection of two pulmonary nodules that were suspicious of metastatic lesions had priority over his cardiac surgery. Prior to abdominal surgery, the patient received 4 × 500 mg intravenous iron (Ferric-Carboxymaltose) over 2 weeks, for correction of iron deficiency and optimization of hemoglobin concentration. This treatment led to rapid improvement of his angina and exertion-induced dyspnea. His hemoglobin concentration continued to rise even after completion of the iron supplementation, and reached normal levels before thoracoscopic removal of the lung nodules, which took place 1 month after resection of the colon tumor. The patient remained in good clinical condition without any need for blood transfusions. As follow-up visits showed persistent abatement of angina and dyspnea, aortic valve surgery and other cardiac interventions were no longer deemed necessary.

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Iron deficiency in heart failure

Cited by 6 publications

References 83 publications

In‐hospital and long‐term mortality for acute heart failure: analysis at the time of admission to the emergency department

In‐hospital and long‐term mortality for acute heart failure: analysis at the time of admission to the emergency department

Role of comorbidities in heart failure prognosis Part I: Anaemia, iron deficiency, diabetes, atrial fibrillation

Resolution of Cardiac Symptoms through Preoperative Intravenous Iron Supplementation in a Cancer Patient

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