Miñana Gema, Lorenzo Miguel, Ramirez de Arellano Antonio, Wächter Sandra, de la Espriella Rafael, Sastre Clara, Mollar Anna, Núñez Eduardo, Bodí Vicent, Sanchis Juan, Bayés-Genís Antoni, Núñez Julio
Cardiology Department, Hospital Clínico Universitario de Valencia, Universitat de Valencia, INCLIVA, 46010 Valencia, Spain.
CIBER Cardiovascular, 28029 Madrid, Spain.
J Clin Med. 2022 May 2;11(9):2559. doi: 10.3390/jcm11092559.
In patients with heart failure (HF), iron deficiency (ID) is a well-recognized therapeutic target; information about its incidence, patterns of iron repletion, and clinical impact is scarce. This single-centre longitudinal cohort study assessed the rates of ID testing and diagnosis in patients with stable HF, patterns of treatment with intravenous iron, and clinical impact of intravenous iron on HF rehospitalization risk. We included 711 consecutive outpatients (4400 visits) with stable chronic HF from 2014 to 2019 (median [interquartile range] visits per patient: 2 [2−7]. ID was defined as serum ferritin <100 µg/L, or 100−299 µg/L with transferrin saturation (TSAT) < 20%. During a median follow-up of 2.20 (1.11−3.78) years, ferritin and TSAT were measured at 2230 (50.7%) and 2183 visits (49.6%), respectively. ID was found at 846 (37.9%) visits, with ferritin and TSAT available (2230/4400), and intravenous iron was administered at 321/4400 (7.3%) visits; 233 (32.8%) patients received intravenous iron during follow-up. After multivariate analyses, iron repletion at any time during follow-up was associated with a lower risk of recurrent HF hospitalization (hazard ratio [HR] = 0.50, 95% confidence interval [CI] = 0.28−0.88; p = 0.016). Thus, ID was a frequent finding in patients with HF, and its repletion reduced the risk of recurrent HF hospitalizations.
在心力衰竭（HF）患者中，缺铁（ID）是一个公认的治疗靶点；关于其发病率、铁补充模式及临床影响的信息匮乏。这项单中心纵向队列研究评估了稳定型HF患者的ID检测和诊断率、静脉铁剂治疗模式以及静脉铁剂对HF再住院风险的临床影响。我们纳入了2014年至2019年连续711例稳定型慢性HF门诊患者（共4400次就诊）（每位患者就诊次数的中位数[四分位间距]：2[2 - 7]次）。ID定义为血清铁蛋白<100μg/L，或铁蛋白为100 - 299μg/L且转铁蛋白饱和度（TSAT）<20%。在中位随访2.20（1.11 - 3.78）年期间，分别在2230次（50.7%）就诊时检测了铁蛋白，在2183次（49.6%）就诊时检测了TSAT。在有铁蛋白和TSAT数据的2230次就诊中，有846次（37.9%）发现ID，在4400次就诊中有321次（7.3%）给予静脉铁剂治疗；233例（32.8%）患者在随访期间接受了静脉铁剂治疗。多因素分析后，随访期间任何时间进行铁补充均与较低的HF复发住院风险相关（风险比[HR]=0.50，95%置信区间[CI]=0.28 - 0.88；p = 0.016）。因此，ID在HF患者中很常见，补充铁剂可降低HF复发住院的风险。
