Dynamic iron status after acute heart failure

• Published in: Archives of cardiovascular diseases 2019-06, Vol.112 (6-7), p.410-419
• Main Authors: Sportouch, Laura, Cautela, Jennifer, Resseguier, Noémie, Pinto, Johan, Ammar, Chloé, Gaubert, Mélanie, Barraud, Jérémie, Peyrol, Michael, Laine, Marc, Bonello, Laurent, Yvorra, Serge, Paganelli, Franck, Thuny, Franck
• Format: Article
• Language: English
• Subjects: Acute Disease; Acute heart failure; Aged; Aged, 80 and over; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - diagnosis; Anemia, Iron-Deficiency - epidemiology; Biomarkers - blood; Cardiology and cardiovascular system; Carence en fer; Co-morbidity; Comorbidity; Comorbidité; Female; Ferritins - blood; France - epidemiology; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - epidemiology; Human health and pathology; Humans; Insuffisance cardiaque aiguë; Iron - blood; Iron - deficiency; Life Sciences; Male; Middle Aged; Patient Admission; Patient Discharge; Prevalence; Risk Factors; Time Factors; Transferrin - metabolism
• ISSN: 1875-2136; 1875-2128
• DOI: 10.1016/j.acvd.2019.02.002

Iron deficiency (ID) is common in heart failure (HF), and is associated with unfavourable clinical outcomes. Although it is recommended to screen for ID in HF, there is no clear consensus on the optimal timing of its assessment. To analyse changes in iron status during a short-term follow-up in patients admitted for acute HF. Iron status (serum ferritin concentration and transferrin saturation) was determined in 110 consecutive patients (median age: 81 years) admitted to a referral centre for acute HF, at three timepoints (admission, discharge and 1 month after discharge). ID was defined according to the guidelines. The prevalence rates of ID at admission, discharge and 1 month were, respectively, 75% (95% confidence interval [CI] 67–83%), 61% (95% CI: 52–70%), and 70% (95% CI: 61–79%) (P=0.008). Changes in prevalence were significant between admission and discharge (P=0.0018). Despite a similar ID prevalence at admission and 1 month (P=0.34), iron status changed in 25% of patients. Between admission and discharge, variation in C-reactive protein correlated significantly with that of ferritin (ρ=0.30; P=0.001). Advanced age, anaemia, low ferritin concentration and low creatinine clearance were associated with the persistence of ID from admission to 1 month. Iron status is dynamic in patients admitted for acute HF. Although ID was as frequent at admission as at 1 month after discharge, iron status varied in 25% of patients. La carence martiale (CM) est fréquente dans l’insuffisance cardiaque (IC) et associée à un pronostic défavorable. Bien qu’il soit recommandé de la dépister au cours de l’IC, il n’existe pas de consensus quant au moment optimal de réalisation du bilan martial. Nous avons analysé l’évolution du bilan martial au cours du suivi à court terme de patients hospitalisés pour IC aiguë. Un bilan martial (taux sérique de ferritine et coefficient de saturation de la transferrine) a été effectué chez 110 patients consécutifs (âge médian : 81 ans) admis pour IC aiguë dans un centre de référence à trois moments différents (admission, sortie et 1 mois après la sortie). La carence martiale était définie conformément aux guidelines. Les taux de prévalence de la CM à l’admission, à la sortie et à 1 mois étaient respectivement de 75 % (intervalle de confiance [IC] 95 %, 67 % 83 %), 61 % (IC : 95 %, 52 % 70 %) et 70 % (IC : 95 %, 61 % 79 %) (p=0,008). Ces changements de prévalence étaient significatifs entre l’admission et la sortie (p=0,0018). Malgré une pr