J Korean Med Sci.  2023 Jun;38(23):e177. 10.3346/jkms.2023.38.e177.

Iron Deficiency in Korean Patients With Heart Failure

• Park JJ
• Yoon M
• Cho HW
• Lee SE
• Choi JO
• Yoo BS
• Kang SM
• Choi DJ

• KMID: 2543869
• DOI: http://doi.org/10.3346/jkms.2023.38.e177

Abstract

Background
Although iron deficiency (ID) is an important and treatable risk factor for heart failure (HF), data on ID are scarce in Asian patients with HF. Therefore, we sought to determine the prevalence and clinical characteristics of ID in hospitalized Korean patients with HF.
Methods
In this prospective, multicenter cohort study, 461 patients with acute HF seen at five tertiary centers from January to November 2019 in Korea were enrolled. ID was defined as serum ferritin < 100 μg/L or ferritin 100–299 μg/L in combination with transferrin saturation < 20%.
Results
The patients’ mean age was 67.6 ± 14.9 years, and 61.8% were male. Among total 461 patients, ID was present in 248 patients (53.8%). The prevalence of ID was significantly higher in women than in men (65.3% vs. 47.3%, P < 0.001). In a multivariable logistic regression analysis, the independent predictors of ID were female sex (odds ratio [OR], 2.19; 95% confidence interval [CI], 1.47–3.30), valvular heart disease (OR, 2.10; 95% CI, 1.10–4.17), higher heart rate (OR, 1.10; 95% CI, 1.01–1.21), anemia (OR, 1.60; 95% CI, 1.07–2.40), and the use of clopidogrel (OR, 1.56; 95% CI, 1.00–2.45). Among women, the prevalence of ID did not significantly differ between younger and older women (< 65 years: 73.7% vs. ≥ 65 years: 63.0%, P = 0.222), those with low and high body mass index (BMI < 25 kg/m² : 66.2% vs. BMI ≥ 25 kg/m² : 69.6%, P = 0.703), or those with low and high natriuretic peptide (NP) levels (NP < median: 69.8% vs. NP ≥ median: 61.1%, P = 0.295). Only 0.2% patients with acute HF received intravenous iron supplementation in Korea.
Conclusion
The prevalence of ID is high in hospitalized Korean patients with HF. Because ID cannot be diagnosed by clinical parameters, routine laboratory examinations are necessary to identify patients with ID.

Keyword

Iron Deficiency; Iron Deficiency Anemia; Heart Failure; Anemia

Figure

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  Fig. 1 Prevalence of various parameters regarding iron deficiency and anemia. (A) Prevalence of iron deficiency. (B) Prevalence of iron deficiency anemia. (C) Prevalence of iron deficiency and iron deficiency anemia. (D) Treatment pattern of anemia.ID = iron deficiency, IDA = iron deficiency anemia, IV = intravenous.

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