title: Iron deficiency status irrespective of anemia: a predictor of unfavorable outcome in chronic heart failure patients.
abstract: OBJECTIVE
  To assess the prognostic significance of iron deficiency (ID) in a chronic heart failure (CHF) outpatient population.
  
  
  RESULTS
  We prospectively evaluated 127 patients with stable CHF and left ventricular ejection fraction ≤45%. Clinical and analytical data as well as information regarding the occurrence of the composite endpoint of overall mortality and nonfatal cardiovascular events were assessed. Among the 127 patients enrolled [81% men, median age: 62 years (25th-75th percentile: 53-68)], 46 (36%) patients had ID. Women, patients with higher plasma brain natriuretic peptide levels (>400 pg/ml) and with right ventricular systolic dysfunction presented ID more frequently (p < 0.05 for all). At 225 ± 139 days of follow-up, the composite endpoint occurred in 15 (12%) patients. It was more frequent in ID (24 vs. 5%, p = 0.001) and anemic patients (25 vs. 8%, p = 0.014). In a Cox regression analysis, ID was associated with a higher likelihood of composite endpoint occurrence (HR 5.00, 95% CI 1.59-15.78, p = 0.006). In a multivariable analysis adjusted for clinical variables, including the presence of anemia, ID remained a significant predictor of the composite endpoint (HR 5.38, 95% CI 1.54-18.87, p = 0.009).
  
  
  CONCLUSIONS
  In a CHF outpatient population, ID carried a higher risk of unfavorable outcome, irrespectively of the presence of anemia.
authors.affiliation: Cardiology Department, Centro Hospitalar de S. João, Porto, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Rangel
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gonçalves
authors.forename: Carla
authors.initials: C
authors.lastname: de Sousa
authors.forename: Sérgio
authors.initials: S
authors.lastname: Leite
authors.forename: Manuel
authors.initials: M
authors.lastname: Campelo
authors.forename: Elisabete
authors.initials: E
authors.lastname: Martins
authors.forename: Sandra
authors.initials: S
authors.lastname: Amorim
authors.forename: Brenda
authors.initials: B
authors.lastname: Moura
authors.forename: José
authors.initials: J
authors.lastname: Silva Cardoso
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Maciel
mesh_terms: D000368:Aged; D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000150:complications; D006801:Humans; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014168:Transferrin / Q000032:analysis
chemical_list: D014168:Transferrin; D007501:Iron