Heart Failure and Valvular Heart Disease Unit, Mediterranean University Cardio-Oncology (MEDI-CO) Centre, Department of Cardiology, Aix-Marseille University, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; Inserm 1263, INRA, centre de recherche cardiovasculaire et nutrition (C2VN), Aix-Marseille University, 13385 Marseille, France.
Research Unit EA 3279, Department of Public Health, Aix-Marseille University, 13385 Marseille, France.
Arch Cardiovasc Dis. 2019 Jun-Jul;112(6-7):410-419. doi: 10.1016/j.acvd.2019.02.002. Epub 2019 Apr 18.
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.
铁缺乏症（ID）在心力衰竭（HF）中很常见，与不良的临床结局相关。尽管建议对 HF 患者进行 ID 筛查，但对于其评估的最佳时机尚无明确共识。
分析急性 HF 住院患者短期随访期间铁状态的变化。
在转诊中心收治的 110 例连续急性 HF 患者（中位年龄：81 岁）中，分别在三个时间点（入院时、出院时和出院后 1 个月）测定铁状态（血清铁蛋白浓度和转铁蛋白饱和度）。根据指南定义 ID。
入院时、出院时和 1 个月时 ID 的患病率分别为 75%（95%置信区间 [CI]：67-83%）、61%（95% CI：52-70%）和 70%（95% CI：61-79%）（P=0.008）。入院时和出院时的患病率变化有统计学意义（P=0.0018）。尽管入院时和 1 个月时 ID 的患病率相似（P=0.34），但仍有 25%的患者铁状态发生了变化。入院至出院期间，C 反应蛋白的变化与铁蛋白的变化显著相关（ρ=0.30；P=0.001）。高龄、贫血、低铁蛋白浓度和低肌酐清除率与从入院到 1 个月时 ID 的持续存在相关。
急性 HF 住院患者的铁状态是动态的。尽管入院时和出院后 1 个月时 ID 的发生率相同，但仍有 25%的患者铁状态发生了变化。
