Clin Res Cardiol 103, Suppl 1, April 2014

V1598 - The Natural Course of Untreated Iron Deficiency in Chronic Heart Failure - 12-Months Follow-Up Analysis from the Prospective German PREP-I Multicenter Registry
J. Dahm1, N. Schön2, U. Gremmler3, J. Schlichting4, F. Mibach5, M. Glowatzki6, C. E. Angermann7, S. von Haehling8
1am Krankenhaus Neu-Bethlehem, Herz- & Gefässzentrum, Göttingen; 2Kardiologisch-angiologische Schwerpunktpraxis, Mühldorf a Inn; 3Kardiologisches Zentrum Peine, Peine; 4Ärztehaus, Herne; 5Praxis, Itzehoe; 6IBM Deutschland GmbH, München; 7Medizinische Klinik und Poliklinik I - CHFC, Deutsches Zentrum für Herzinsuffizienz, Würzburg; 8Medizinische Klinik m. S. Kardiologie, Angewandte Kachexieforschung, Charité - Universitätsmedizin Berlin, Berlin;
Background: Iron plays an essential role in oxygen transport, storage and molecular processes maintaining cellular energy in high-energy demanding tissues like cardiac muscle. The presence of iron deficiency (ID) has been shown to be independently predictive of survival in patients with chronic heart failure (CHF). Based on the data of the PREP-I multicenter study performed by 42 office-based cardiologist in Germany. ID is common among ambulatory CHF patients, with female gender and anemia as independent predictors. Little is known about the natural course of untreated ID in CHF and probable associations to ID influencing co-morbidities.
Patients and Methods: A 12 month follow-up analysis of all PREP-I patients (outpatients with CHF with LVEF<45%) was done. In all patients, where ID (as defined as ferritin <100 ng/mL (absolute ID) or ferritin <300 ng/mL in the presence of transferrin saturation [TSAT] <20% (functional ID), spontaneously disappeared (ID->Non-ID) or developed (Non-ID->ID) during the 12months follow-up period, a multivariate logistic regression analysis considering demographics (gender, age), ID-associated co-morbidities, i.e. diabetes, anemia, renal function (GFR), heart failure symptoms (NYHA-class, LVEF, NT-Pro-BNP) and inflammatory status (CRP) was carried out.
Results: 12 month follow-up data were available for 565 CHF patients. In the course of 12 months (without ID-correcting measures), ID disappeared (ID->Non-ID) spontaneously in 67 of 303 ID pts. (22.1%) and ID newly occurred (Non-ID->ID) in 66 of 262 Non-ID pts. (25.2%) without significant differences between Non-ID->ID vs. ID->Non-ID regarding GFR, diabetes, anemia, NT-ProBNP, CRP, LVEF, NYHA-status or fatigue-score. Multivariate logistic regression revealed a higher probability of developing ID if anemia occurred (p<0.019). All other variables were not significantly associated with the new development or resolution of ID.
Conclusions: Both spontaneous resolution and new development of ID are frequent in chronic heart failure. New onset anemia was the only variable investigated in this study demonstrating a significant correlation with new onset ID. Surprisingly, neither co-morbidities known to be associated with both anemia and ID (diabetes, renal function (GFR), nor parameters of heart failure severity (NYHA-class, LVEF, NT-Pro-BNP) and inflammatory status (CRP) correlated with ID fluctuation.
Clin Res Cardiol 103, Suppl 1, April 2014
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-014-1100-9