LOS ANGELES — What is the relationship of iron status with incident heart failure in community-dwelling older adults, without regard to their kidney function?
That was the question in a new study led by UCLA and the VA Greater Los Angeles Healthcare System sought to answer. “Among persons with prevalent heart failure (HF), iron deficiency has been linked to HF admissions, and intravenous iron replacement improves HF outcomes,” the researchers noted. “Recent studies in persons with chronic kidney disease (CKD) demonstrate that iron deficiency is associated with incident HF,” they wrote.
For the case-cohort study published in ESC Heart Failure, the investigative team focused on 1,006 Cardiovascular Health Study participants (785 from the random sub-cohort [including 193 HF cases] and 221 additional HF cases [N = 414 total HF cases]). Participants were aged 65 and older without HF, although 41% had CKD.
Consistent with prior studies, participants were categorized based on quartiles of transferring saturation and ferritin as:
- iron replete (27.3%),
- functional iron deficiency (7.7%),
- iron deficiency (11.8%),
- mixed iron deficiency (5.6%),
- high iron (9.3%) and
- nonclassified” (38.1%).
“Compared to older persons who were iron replete, those with iron deficiency were at higher risk of incident HF (HR 1.47; 1.02-2.11) in models adjusting for demographics, HF risk factors, and estimated glomerular filtration rate,” the authors wrote. “Other iron categories did not associate with incident HF. The relationship of iron deficiency with incident HF did not differ by CKD status (interaction P value 0.2).”
The study concluded that, among community-dwelling elders, iron deficiency is independently associated with incident HF, an association that was similar irrespective of CKD status. “Our findings support conduct of clinical trials of iron replacement for prevention of HF in older adults with iron deficiency,” the researchers added.
- Sharma S, Katz R, Chaves PHM, Hoofnagle AN, Kizer JR, Bansal N, Ganz T, Ix JH. Iron Deficiency and Incident Heart Failure in Older Community-Dwelling Individuals. ESC Heart Fail. 2024 Jun;11(3):1435-1442. doi: 10.1002/ehf2.14724. Epub 2024 Feb 26. PMID: 38407565; PMCID: PMC11098627.
