Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study.
Patients affected by chronic heart failure (CHF) present significant impairment of health-related quality of life (HRQoL). Iron deficiency (ID) is a common comorbidity in CHF with negative impact in prognosis and functional capacity. The role of iron in energy metabolism could be the link between ID and HRQoL. There is little information about the role of ID on HRQoL in patients with CHF. We evaluate the impact of ID on HRQoL and the interaction with the anaemia status, iron status, clinical baseline information and HRQoL, measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) was obtained at baseline in an international cohort of 1278 patients with CHF. Baseline characteristics were median age 68 ± 12, 882 (69%) were males, ejection fraction was 38% ± 15 and NYHA class was I/II/III/IV (156/247/487/66). ID (defined as ferritin level< 100 µg/L or serum ferritin 100-299 µg/L in combination with a TSAT<20%) was present in 741 patients (58%). 449 (35%) patients were anaemic. Unadjusted global scores of MLHFQ (where higher scores reflect worse HRQoL) were worse in ID and anaemic patients (ID+: 42 ± 25 vs. ID-: 37 ± 25; p-value=0.001 and A+: 46 ± 25 vs. A-: 37 ± 25; p-value<0.001). The combined influence of ID and anaemia was explored with different multivariable regression models, showing that ID but not anaemia was associated with impaired HRQoL. ID has a negative impact on HRQoL in CHF patients, and this is independent of the presence of anaemia.
Heart Diseases Biomedical Research Group, Program of Research in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Cristina
C
Enjuanes
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ijsbrand T
IT
Klip
Heart Diseases Biomedical Research Group, Program of Research in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Jordi
J
Bruguera
Heart Diseases Biomedical Research Group, Program of Research in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Merce
M
Cladellas
Center for Heart Diseases, Military Hospital, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Poland.
Piotr
P
Ponikowski
Center for Heart Diseases, Military Hospital, Wroclaw, Poland.
Waldemar
W
Banasiak
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Dirk J
DJ
van Veldhuisen
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Peter
P
van der Meer
Center for Heart Diseases, Military Hospital, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Poland; Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Ewa A
EA
Jankowska
Heart Diseases Biomedical Research Group, Program of Research in Inflammatory and Cardiovascular Disorders, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: josepcomin@gmail.com.
Josep
J
Comín-Colet
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D000090463:Iron Deficiencies; D019189:Iron Metabolism Disorders / Q000150:complications*; D008297:Male; D011788:Quality of Life
Anaemia; Health related quality of life; Iron deficiency