The relationship between iron-deficient patients with acute heart failure and the New York Heart Association (NYHA) classes and left ventricular ejection fraction (LVEF)

Abstract

Introduction: iron deficiency is common in patients with heart failure and is also recognized as a risk factor for worsening symptoms, impaired quality of life and a poor prognosis in this population. The objective of this study was to describe the clinical characteristics of patients with heart failure and explore an association between serum iron levels and the New York Heart Association (NYHA) functional classes and left ventricular ejection fraction (LVEF).

Method: this was an observational, analytical, cross-sectional study of hospitalized patients from the mideastern integrated healthcare services subnetwork in Bogotá, Colombia. Sociodemographic, clinical and laboratory variables were analyzed using univariate and bivariate analysis and simple logistic regression to calculate the odds ratio (OR).

Results: a total of 139 patients hospitalized during the study period yielded a 43% prevalence of heart failure with mildly reduced LVEF; the average age was 53 years and 67.6% were male, with comorbidities like atrial fibrillation (23.2%), coronary disease (59%) and dyslipidemia (27.9%). Altogether, 57.2% of the patients had iron deficiency. The factors associated with NYHA III and IV were male sex (OR: 2.8; 95% CI: 1.17;6.97), chronic obstructive pulmonary disease (OR: 2.7; 95% CI: 1.03;7.23), and iron deficiency (OR: 1.92; 95% CI: 1.13;3.25).

Conclusions: most patients with iron deficiency and heart failure had a mildly reduced LVEF, anemia, low ferritin levels and low transferrin saturation. The need to measure the iron kinetics profile of all patients with decompensated heart failure is stressed. The factors associated with NYHA classes III and IV as well as reduced ejection fraction were male sex, chronic obstructive pulmonary disease, hemoglobin < 13 g/dL, and a history of coronary disease