Iron Deficiency in Patients With Congestive Heart Failure

Abstract

A large percentage of patients with chronic heart failure (HF) have anemia, defined as hemoglobin (Hb) of <12 g/dl, hovering around 30% in non-hospitalized HF patients and about 50% of hospitalized patients.^1,2 The presence of anemia is an independent risk factor, associated with increased rates of mortality, HF hospitalization and morbidity. The cause of anemia in HF is multifactorial with 63.8% of patients having at least two factors that cause anemia. Chronic kidney insufficiency, iron deficiency, vitamin B12 deficiency, hemodilution, chronic diseases, and cachexia are the most common causes.3   Iron deficiency with or without anemia is common in patients with HF, relates to disease severity, and is a strong and independent predictor of outcome.⁴ Iron deficiency is defined as a ferritin level < 100μg/L or ferritin level 100-299 μg/L with a transferrin saturation < 20%.⁴ Anemic patients were more often iron deficient than non anemic patients.  There are two types of iron deficiency, the absolute and the functional iron deficiency (Fig. 2)... (excerpt)