Abstract
Background: Heart failure is a leading killer worldwide, with concurrent anaemia and iron deficiency portending sepulchral prognosis. Anaemia is rampant, with 53% prevalence in Indian females, but iron deficiency can be present even without anaemia. Therefore, this study was planned to determine the clinical profile, red blood cell indices, and effects of iron deficiency, on the course and prognosis of heart failure in Indian females.Materials and methods: This was a hospital-based observational study, conducted at a tertiary care teaching institute in India. Data from 147 females enrolled in the study between September 2017 to March 2020 was collected out of all patients enrolled in ongoing heart failure registry at the institute. Clinical characteristics at presentation, iron profile, red blood cell indices, treatment and mortality data was collected.Results: Mean age of the subjects (n = 147) was 53.31 ± 17.1 years with 55% non-rheumatic and 45% with rheumatic heart disease. The patients with rheumatic heart disease were younger, with a higher prevalence of atrial fibrillation. Non-rheumatic patients had a higher prevalence of CV risk factors like diabetes, hypertension, renal failure, more patients in NYHA IV, and 83% patients had LVEF ≤40%. Anaemia was present in 49%, however iron deficiency was present in 89% (absolute iron deficiency in 80% and functional iron deficiency in 9%) with no significant difference between rheumatic and non-rheumatic group. Red blood cell indices showed no significant difference across the spectrum of iron deficiency and anaemia, except lower mean corpuscular volume in patients with both iron deficiency and anaemia. The mean survival time was 840 days, with no significant difference between groups. There was significantly higher mortality in patients with iron deficiency (log rank 0.045).Conclusion: Iron deficiency–with or without anaemia–is very high in Indian females, worsening survival in heart failure. Proper diagnosis with iron supplementation will improve the prognosis.
Highlights
Heart failure (HF) is a leading cause of morbidity and mortality worldwide and is a major burden on public health system
A total of 147 females with HF were included in the study, out of which 66 had rheumatic and 81 had non-rheumatic etiology (Table 1)
There was significant difference in cardiovascular risk factors like diabetes (p = 0.0003), hypertension (p = 0.0019) and renal failure (p = 0.03), all were more common in heart failure with non-rheumatic etiology
Summary
Heart failure (HF) is a leading cause of morbidity and mortality worldwide and is a major burden on public health system It is the primary cause of hospitalisation in patients above 65 years of age with re-admission rates of 38% in the first month and 43% in 6–12 months[1]. With the increase in the incidence and prevalence of diabetes, hypertension and dyslipidemia in India, there is increased trend of patients with non-rheumatic HF as noted in the Trivandrum Heart Failure registry[2]. This study was planned to determine the clinical profile, red blood cell indices, and effects of iron deficiency, on the course and prognosis of heart failure in Indian females. Iron profile, red blood cell indices, treatment and mortality data was collected.
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