Abstract 11803: Applicability of the New Proposed Criteria for Iron Deficiency in Japanese Patients With Heart Failure

Abstract

Backgrounds: Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF). A recent study from a large single-center chronic HF cohort including predominantly white British population showed that ID defined by current guideline criteria was not associated with poor outcome, and a new ID criteria targeting for HF population was proposed. However, its external applicability is unclear. Methods: We prospectively examined consecutive 711 chronic HF patients and measured serum iron, transferrin saturation (TSAT) and serum ferritin from a Japanese multicenter registry. The proposed ID criteria were TSAT <20% and serum iron ≤13 mmol/L and the guideline ID criteria were serum ferritin <100 ng/mL or, when ferritin was 100-299 ng/mL, TSAT <20%. The primary outcome was all-cause death. Results: Of studied patients (433 male, mean age 71 ± 13 years, mean left ventricular ejection fraction 47 ± 16%), 198 (28%) and 416 (59%) met the proposed and guideline ID criteria, respectively. During a median follow-up period of 441 (IQR 306-564) days, the primary outcome occurred in 50 patients. There was no significant difference on primary outcome between the patients with and without guideline ID criteria ( P = 0.24) ( Figure A ), while patients with serum iron ≤10 mmol/L showed a higher mortality than those without ( P = 0.004) ( Figure B ). In multivariable Cox regressions, the proposed ID criteria, but not guideline ID criteria, were independently associated with higher mortality (HR 1.92, 95% CI 1.06-3.47; and HR 1.42; 95% CI 0.79-1.24, respectively) adjusted for significant covariates including age, hemoglobin, estimated glomerular filtration rate and log NT-proBNP, and the Meta-Analysis Global Group in Chronic Heart Failure risk score. Conclusions: As defined by the proposed criteria, but not the guideline criteria, ID was associated with higher mortality in patients with chronic HF, suggesting that the proposed ID criteria might be applicable to Japanese population.