IRON DEFICIENCY WITH AND WITHOUT ANEMIA IN PATIENTS OF HEART FAILURE WITH REDUCED EJECTION FRACTION

Abstract

Iron deficiency (ID) is the most common dietary deficiency in the world and the leading cause of anemia. Iron deficiency can lead to symptoms both due to the lack of iron and due to the resultant anemia. Heart failure patients can develop iron deficiency (ID) by various mechanisms. Considering that iron levels may vary in different geographical regions according to economic, environmental, infectious, and genetic factors, this study was particularly devoted for studying iron deficiency in heart failure patients irrespective of presence of anemia. Patients >18 years diagnosed with heart failure on the basis of clinical and biochemical parameters and an ejection fraction ≤40% on transthoracic echocardiography were recruited and biochemical parameters and iron profile was analysed for the presence of iron deficiency. The study subjects' mean ejection fraction was 35.02±4.56%. The mean age was 59.33± 14.06 years. The study involved 90 patients, of whom 69 (76.7%) were classified as iron deficient because their S. ferritin levels were less than 100 μg/L and/or their transferrin saturation was less than 20%. The remaining 21 patients were classified as having normal iron levels. NT pro-BNP was significantly higher in iron deficient cases than those with normal iron (7822±7047 vs. 2673±1806 pg/ml). In the present study 76.7% of individuals with heart failure and a decreased ejection fraction had iron insufficiency. Further studies with larger sample size to correlate grades of HF with ID strata are recommended. This has got therapeutic potential and lays scaffold for prospective studies.