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Prevalence and prognostic impact of anaemia, renal insufficiency, and iron deficiency in patients discharged from hospital after decompensation for systolic heart failure

Session Moderated Poster Session - Acute heart failure

Speaker Stefan Stoerk

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Moderated Posters

Authors : M Kordsmeyer (Wurzburg,DE), G Gueder (Wurzburg,DE), C Morbach (Wurzburg,DE), M Kaspar (Wurzburg,DE), S Brenner (Wurzburg,DE), S Stoerk (Wurzburg,DE), G Ertl (Wurzburg,DE), CE Angermann (Wurzburg,DE)

Authors:
M Kordsmeyer1 , G Gueder2 , C Morbach2 , M Kaspar1 , S Brenner2 , S Stoerk1 , G Ertl2 , CE Angermann1 , 1Comprehensive Heart Failure Center (CHFC) - Wurzburg - Germany , 2University Hospital of Wurzburg - Wurzburg - Germany ,

On behalf: INH Study Group

Citation:

Background: Anaemia (A), renal insufficiency (RI), and iron deficiency (ID) are common in heart failure (HF) and associated with adverse outcomes.

Purpose: This study investigated the prevalence of A, RI, and ID and their individual and cumulative impact on 18-month all-cause mortality (ACM) in patients discharged from hospital after admission for decompensated HF with reduced ejection fraction (HFrEF).

Methods: This post-hoc analysis was performed with participants of the Interdisciplinary Network for HF (INH) program. Out of 1022 consecutive patients, 953 patients (68.0±12.3 years, 28.3% female) had laboratory values to define A, RI, and ID available at baseline and were thus included into the current analysis. Follow-up was 18 months (100% complete). Participants were divided into eight groups according to the presence/absence of A (defined as haemoglobin <13/12g/dL in men/women), RI (estimated glomerular filtration rate <60mL/min/1.73m²), and ID (ferritin <100µg/L or ferritin 100-299 µg/L plus transferrin saturation <20%). For survival analyses log rank tests and multivariable Cox regression models (not shown) were used.

Results: Overall, the baseline prevalence of A was 30.6%, of RI 42.0%, and of ID 47.2%. 74.4% of patients had at least one comorbidity and 9.3% showed all three comorbidities. The figure shows the prevalence of the three comorbidities alone and combined (A) and the individual and cumulative impact on ACM (B). Hazard Ratios indicated that isolated ID had no significant impact on ACM. The risk for ACM was highest in patients with A and RI with or without ID. When only the latter two groups were compared, patients with A and RI without ID appeared to be at higher risk for ACM.

Conclusions: Our findings in this large cohort of survivors of the in-hospital phase demonstrate, that A, RI, and ID are common and often coincide in patients after acutely decompensated HFrEF. Patients with A and RI with or without ID had the highest risk of ACM. The prognostic role of ID after acute cardiac decompensation requires further evaluation.

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