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Iron deficiency: an ominous sign in patients with systolic chronic heart failure
Aims Beyond erythropoiesis, iron is involved in numerous biological processes crucial for maintenance of homeostasis. Patients with chronic heart failure (CHF) are prone to develop iron deficiency (ID), and iron supplementation improves their functional status and quality of life. We sought to exami...
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| Published in: | European heart journal 2010-08, Vol.31 (15), p.1872-1880 |
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| container_title | European heart journal |
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| creator | Jankowska, Ewa A. Rozentryt, Piotr Witkowska, Agnieszka Nowak, Jolanta Hartmann, Oliver Ponikowska, Beata Borodulin-Nadzieja, Ludmila Banasiak, Waldemar Polonski, Lech Filippatos, Gerasimos McMurray, John J.V. Anker, Stefan D. Ponikowski, Piotr |
| description | Aims Beyond erythropoiesis, iron is involved in numerous biological processes crucial for maintenance of homeostasis. Patients with chronic heart failure (CHF) are prone to develop iron deficiency (ID), and iron supplementation improves their functional status and quality of life. We sought to examine the relationship between ID and survival in patients with systolic CHF. Methods and results In a prospective observational study, we evaluated 546 patients with stable systolic CHF [age: 55 ± 11 (mean ± standard deviation) years, males: 88%, left ventricular ejection fraction: 26 ± 7%, New York Heart Association (NYHA) class (I/II/III/IV): 57/221/226/42]. Iron deficiency was defined as: ferritin |
| doi_str_mv | 10.1093/eurheartj/ehq158 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_748933149</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>748933149</sourcerecordid><originalsourceid>FETCH-LOGICAL-c366t-84a2ba45ccd6ed837ee7e2f04bdabdac1e019557e934c1aef21b7a4d4355e1bb3</originalsourceid><addsrcrecordid>eNpFkEtLAzEUhYMotj72riQbcTWaTF4z7qT4goIKCsVNyGTu2NTpTJvMoP33RlsrXDiL-53D4SB0QskFJTm7hN5PwfhudgnTJRXZDhpSkaZJLrnYRUNCc5FImU0G6CCEGSEkk1Tuo0FKhCK5SIfo6cG3DS6hctZBY1dX2DS4nbum7QMO7r3BrsEL08VnF_Cn66Y4rELX1s5iO43eqL8VcGVc3Xs4QnuVqQMcb_QQvd7evIzuk_Hj3cPoepxYJmWXZNykheHC2lJCmTEFoCCtCC9KE89S-CkvFOSMW2qgSmmhDC85EwJoUbBDdL7OXfh22UPo9NwFC3VtGojdteJZzhjleSTJmrS-DcFDpRfezY1faUr0z4x6O6Nezxgtp5vwvphDuTX87RaBsw1ggjV15U1jXfjnGOFUMhW5ZM250MHX9m_8h5aKKaHvJ29ajTi5e36aaMK-Acsrj2c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>748933149</pqid></control><display><type>article</type><title>Iron deficiency: an ominous sign in patients with systolic chronic heart failure</title><source>Oxford Journals Online</source><creator>Jankowska, Ewa A. ; Rozentryt, Piotr ; Witkowska, Agnieszka ; Nowak, Jolanta ; Hartmann, Oliver ; Ponikowska, Beata ; Borodulin-Nadzieja, Ludmila ; Banasiak, Waldemar ; Polonski, Lech ; Filippatos, Gerasimos ; McMurray, John J.V. ; Anker, Stefan D. ; Ponikowski, Piotr</creator><creatorcontrib>Jankowska, Ewa A. ; Rozentryt, Piotr ; Witkowska, Agnieszka ; Nowak, Jolanta ; Hartmann, Oliver ; Ponikowska, Beata ; Borodulin-Nadzieja, Ludmila ; Banasiak, Waldemar ; Polonski, Lech ; Filippatos, Gerasimos ; McMurray, John J.V. ; Anker, Stefan D. ; Ponikowski, Piotr</creatorcontrib><description><![CDATA[Aims Beyond erythropoiesis, iron is involved in numerous biological processes crucial for maintenance of homeostasis. Patients with chronic heart failure (CHF) are prone to develop iron deficiency (ID), and iron supplementation improves their functional status and quality of life. We sought to examine the relationship between ID and survival in patients with systolic CHF. Methods and results In a prospective observational study, we evaluated 546 patients with stable systolic CHF [age: 55 ± 11 (mean ± standard deviation) years, males: 88%, left ventricular ejection fraction: 26 ± 7%, New York Heart Association (NYHA) class (I/II/III/IV): 57/221/226/42]. Iron deficiency was defined as: ferritin <100 µg/L, or 100–300 µg/L with transferrin saturation <20%. The prevalence of ID was 37 ± 4% [±95% confidence intervals (CI)] in the entire CHF population (32 ± 4 vs. 57 ± 10%—in subjects without vs. with anaemia defined as haemoglobin level <12 g/dL in women and <13 g/dL in men, P < 0.001). In a multiple logistic model, ID was more prevalent in women, those in the advanced NYHA class, with higher plasma N-terminal pro-type B natriuretic peptide and higher serum high-sensitivity C-reactive protein (all P < 0.05). At the end of follow-up (mean duration: 731 ± 350 days), there were 153 (28%) deaths and 30 (6%) heart transplantations (HTX). In multivariable models, ID (but not anaemia) was related to an increased risk of death or HTX (adjusted hazard ratio 1.58, 95% CI 1.14–2.17, P < 0.01). Conclusion In patients with systolic CHF, ID is common and constitutes a strong, independent predictor of unfavourable outcome. Iron supplementation may be considered as a therapeutic approach in these patients to improve prognosis.]]></description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehq158</identifier><identifier>PMID: 20570952</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Anemias. Hemoglobinopathies ; Biological and medical sciences ; C-Reactive Protein - metabolism ; Cardiology. Vascular system ; Chronic Disease ; Chronic heart failure ; Disease-Free Survival ; Diseases of red blood cells ; Female ; Ferritins - blood ; Heart ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Failure, Systolic - complications ; Heart Failure, Systolic - metabolism ; Hematologic and hematopoietic diseases ; Humans ; Iron - deficiency ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Metabolic diseases ; Metals (hemochromatosis...) ; Middle Aged ; Natriuretic Peptide, Brain - metabolism ; Other metabolic disorders ; Peptide Fragments - metabolism ; Prognosis ; Prospective Studies ; Survival ; Transferrin - metabolism</subject><ispartof>European heart journal, 2010-08, Vol.31 (15), p.1872-1880</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-84a2ba45ccd6ed837ee7e2f04bdabdac1e019557e934c1aef21b7a4d4355e1bb3</citedby><cites>FETCH-LOGICAL-c366t-84a2ba45ccd6ed837ee7e2f04bdabdac1e019557e934c1aef21b7a4d4355e1bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23041637$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20570952$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jankowska, Ewa A.</creatorcontrib><creatorcontrib>Rozentryt, Piotr</creatorcontrib><creatorcontrib>Witkowska, Agnieszka</creatorcontrib><creatorcontrib>Nowak, Jolanta</creatorcontrib><creatorcontrib>Hartmann, Oliver</creatorcontrib><creatorcontrib>Ponikowska, Beata</creatorcontrib><creatorcontrib>Borodulin-Nadzieja, Ludmila</creatorcontrib><creatorcontrib>Banasiak, Waldemar</creatorcontrib><creatorcontrib>Polonski, Lech</creatorcontrib><creatorcontrib>Filippatos, Gerasimos</creatorcontrib><creatorcontrib>McMurray, John J.V.</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Ponikowski, Piotr</creatorcontrib><title>Iron deficiency: an ominous sign in patients with systolic chronic heart failure</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description><![CDATA[Aims Beyond erythropoiesis, iron is involved in numerous biological processes crucial for maintenance of homeostasis. Patients with chronic heart failure (CHF) are prone to develop iron deficiency (ID), and iron supplementation improves their functional status and quality of life. We sought to examine the relationship between ID and survival in patients with systolic CHF. Methods and results In a prospective observational study, we evaluated 546 patients with stable systolic CHF [age: 55 ± 11 (mean ± standard deviation) years, males: 88%, left ventricular ejection fraction: 26 ± 7%, New York Heart Association (NYHA) class (I/II/III/IV): 57/221/226/42]. Iron deficiency was defined as: ferritin <100 µg/L, or 100–300 µg/L with transferrin saturation <20%. The prevalence of ID was 37 ± 4% [±95% confidence intervals (CI)] in the entire CHF population (32 ± 4 vs. 57 ± 10%—in subjects without vs. with anaemia defined as haemoglobin level <12 g/dL in women and <13 g/dL in men, P < 0.001). In a multiple logistic model, ID was more prevalent in women, those in the advanced NYHA class, with higher plasma N-terminal pro-type B natriuretic peptide and higher serum high-sensitivity C-reactive protein (all P < 0.05). At the end of follow-up (mean duration: 731 ± 350 days), there were 153 (28%) deaths and 30 (6%) heart transplantations (HTX). In multivariable models, ID (but not anaemia) was related to an increased risk of death or HTX (adjusted hazard ratio 1.58, 95% CI 1.14–2.17, P < 0.01). Conclusion In patients with systolic CHF, ID is common and constitutes a strong, independent predictor of unfavourable outcome. Iron supplementation may be considered as a therapeutic approach in these patients to improve prognosis.]]></description><subject>Aged</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Biological and medical sciences</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cardiology. Vascular system</subject><subject>Chronic Disease</subject><subject>Chronic heart failure</subject><subject>Disease-Free Survival</subject><subject>Diseases of red blood cells</subject><subject>Female</subject><subject>Ferritins - blood</subject><subject>Heart</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Failure, Systolic - complications</subject><subject>Heart Failure, Systolic - metabolism</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Iron - deficiency</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Metals (hemochromatosis...)</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - metabolism</subject><subject>Other metabolic disorders</subject><subject>Peptide Fragments - metabolism</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Survival</subject><subject>Transferrin - metabolism</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNpFkEtLAzEUhYMotj72riQbcTWaTF4z7qT4goIKCsVNyGTu2NTpTJvMoP33RlsrXDiL-53D4SB0QskFJTm7hN5PwfhudgnTJRXZDhpSkaZJLrnYRUNCc5FImU0G6CCEGSEkk1Tuo0FKhCK5SIfo6cG3DS6hctZBY1dX2DS4nbum7QMO7r3BrsEL08VnF_Cn66Y4rELX1s5iO43eqL8VcGVc3Xs4QnuVqQMcb_QQvd7evIzuk_Hj3cPoepxYJmWXZNykheHC2lJCmTEFoCCtCC9KE89S-CkvFOSMW2qgSmmhDC85EwJoUbBDdL7OXfh22UPo9NwFC3VtGojdteJZzhjleSTJmrS-DcFDpRfezY1faUr0z4x6O6Nezxgtp5vwvphDuTX87RaBsw1ggjV15U1jXfjnGOFUMhW5ZM250MHX9m_8h5aKKaHvJ29ajTi5e36aaMK-Acsrj2c</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Jankowska, Ewa A.</creator><creator>Rozentryt, Piotr</creator><creator>Witkowska, Agnieszka</creator><creator>Nowak, Jolanta</creator><creator>Hartmann, Oliver</creator><creator>Ponikowska, Beata</creator><creator>Borodulin-Nadzieja, Ludmila</creator><creator>Banasiak, Waldemar</creator><creator>Polonski, Lech</creator><creator>Filippatos, Gerasimos</creator><creator>McMurray, John J.V.</creator><creator>Anker, Stefan D.</creator><creator>Ponikowski, Piotr</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100801</creationdate><title>Iron deficiency: an ominous sign in patients with systolic chronic heart failure</title><author>Jankowska, Ewa A. ; Rozentryt, Piotr ; Witkowska, Agnieszka ; Nowak, Jolanta ; Hartmann, Oliver ; Ponikowska, Beata ; Borodulin-Nadzieja, Ludmila ; Banasiak, Waldemar ; Polonski, Lech ; Filippatos, Gerasimos ; McMurray, John J.V. ; Anker, Stefan D. ; Ponikowski, Piotr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-84a2ba45ccd6ed837ee7e2f04bdabdac1e019557e934c1aef21b7a4d4355e1bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Anemias. Hemoglobinopathies</topic><topic>Biological and medical sciences</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cardiology. Vascular system</topic><topic>Chronic Disease</topic><topic>Chronic heart failure</topic><topic>Disease-Free Survival</topic><topic>Diseases of red blood cells</topic><topic>Female</topic><topic>Ferritins - blood</topic><topic>Heart</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Failure, Systolic - complications</topic><topic>Heart Failure, Systolic - metabolism</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Iron - deficiency</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Metals (hemochromatosis...)</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - metabolism</topic><topic>Other metabolic disorders</topic><topic>Peptide Fragments - metabolism</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Survival</topic><topic>Transferrin - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jankowska, Ewa A.</creatorcontrib><creatorcontrib>Rozentryt, Piotr</creatorcontrib><creatorcontrib>Witkowska, Agnieszka</creatorcontrib><creatorcontrib>Nowak, Jolanta</creatorcontrib><creatorcontrib>Hartmann, Oliver</creatorcontrib><creatorcontrib>Ponikowska, Beata</creatorcontrib><creatorcontrib>Borodulin-Nadzieja, Ludmila</creatorcontrib><creatorcontrib>Banasiak, Waldemar</creatorcontrib><creatorcontrib>Polonski, Lech</creatorcontrib><creatorcontrib>Filippatos, Gerasimos</creatorcontrib><creatorcontrib>McMurray, John J.V.</creatorcontrib><creatorcontrib>Anker, Stefan D.</creatorcontrib><creatorcontrib>Ponikowski, Piotr</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jankowska, Ewa A.</au><au>Rozentryt, Piotr</au><au>Witkowska, Agnieszka</au><au>Nowak, Jolanta</au><au>Hartmann, Oliver</au><au>Ponikowska, Beata</au><au>Borodulin-Nadzieja, Ludmila</au><au>Banasiak, Waldemar</au><au>Polonski, Lech</au><au>Filippatos, Gerasimos</au><au>McMurray, John J.V.</au><au>Anker, Stefan D.</au><au>Ponikowski, Piotr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iron deficiency: an ominous sign in patients with systolic chronic heart failure</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>31</volume><issue>15</issue><spage>1872</spage><epage>1880</epage><pages>1872-1880</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract><![CDATA[Aims Beyond erythropoiesis, iron is involved in numerous biological processes crucial for maintenance of homeostasis. Patients with chronic heart failure (CHF) are prone to develop iron deficiency (ID), and iron supplementation improves their functional status and quality of life. We sought to examine the relationship between ID and survival in patients with systolic CHF. Methods and results In a prospective observational study, we evaluated 546 patients with stable systolic CHF [age: 55 ± 11 (mean ± standard deviation) years, males: 88%, left ventricular ejection fraction: 26 ± 7%, New York Heart Association (NYHA) class (I/II/III/IV): 57/221/226/42]. Iron deficiency was defined as: ferritin <100 µg/L, or 100–300 µg/L with transferrin saturation <20%. The prevalence of ID was 37 ± 4% [±95% confidence intervals (CI)] in the entire CHF population (32 ± 4 vs. 57 ± 10%—in subjects without vs. with anaemia defined as haemoglobin level <12 g/dL in women and <13 g/dL in men, P < 0.001). In a multiple logistic model, ID was more prevalent in women, those in the advanced NYHA class, with higher plasma N-terminal pro-type B natriuretic peptide and higher serum high-sensitivity C-reactive protein (all P < 0.05). At the end of follow-up (mean duration: 731 ± 350 days), there were 153 (28%) deaths and 30 (6%) heart transplantations (HTX). In multivariable models, ID (but not anaemia) was related to an increased risk of death or HTX (adjusted hazard ratio 1.58, 95% CI 1.14–2.17, P < 0.01). Conclusion In patients with systolic CHF, ID is common and constitutes a strong, independent predictor of unfavourable outcome. Iron supplementation may be considered as a therapeutic approach in these patients to improve prognosis.]]></abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>20570952</pmid><doi>10.1093/eurheartj/ehq158</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Anemias. Hemoglobinopathies Biological and medical sciences C-Reactive Protein - metabolism Cardiology. Vascular system Chronic Disease Chronic heart failure Disease-Free Survival Diseases of red blood cells Female Ferritins - blood Heart Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Failure, Systolic - complications Heart Failure, Systolic - metabolism Hematologic and hematopoietic diseases Humans Iron - deficiency Kaplan-Meier Estimate Male Medical sciences Metabolic diseases Metals (hemochromatosis...) Middle Aged Natriuretic Peptide, Brain - metabolism Other metabolic disorders Peptide Fragments - metabolism Prognosis Prospective Studies Survival Transferrin - metabolism |
| title | Iron deficiency: an ominous sign in patients with systolic chronic heart failure |
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