Prevalence and pattern of Iron deficiency in patient with heart failure with reduced ejection fraction

Authors

  • Aditya Mahaseth BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Jay Narayan Shah BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Bikash Nepal BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Biplave Karki BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Jeet Ghimire BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Naveen Kumar Pandey BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Prashant Shah BP Koirala Institute of Health Sciences, Dharan, Nepal
  • Prahlad Karki BP Koirala Institute of Health Sciences, Dharan, Nepal

DOI:

https://doi.org/10.3126/jmcjms.v7i2.30689

Keywords:

Anemia, Heart Failure, Hemoglobin, Iron deficiency in heart failure

Abstract

Background and Objectives: Iron Deficiency is the commonest nutritional deficiency worldwide, affecting more than one-third of the population, its association with Heart Failure with or without anemia is of growing interest. As iron supplementation improves prognosis in patients with Heart Failure, Iron Deficiency is an attractive therapeutic target – a hypothesis that has recently been tested in clinical studies. This study is designed to estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) with reduced ejection fraction patients with or without anemia.

Material and methods: It was a single center hospital based cross sectional observational study. A total of 60 male and female patients with diagnosis of heart failure based on the Framingham Criteria, who gave consent for the study were included. They underwent laboratory evaluation including hemoglobin concentration, serum iron, transferrin saturation percentage, serum ferritin, total iron binding capacity. Serum ferritin <100 μg/l was used to diagnose absolute ID. Functional ID was defined as a serum ferritin level of 100–300 μg/l and a transferrin saturation of <20 %. Anemia was defined as hemoglobin (Hb) <13 g/dl for males and <12 g/dl for females, based on World Health Organization definition.

Results: Using the above definitions iron deficiency was found in 28 (46.67%) patients. 36.67% patients had absolute iron deficiency and 10% patients had functional iron deficiency. Females had a higher non statistically significant iron deficiency than males 63.16% vs 39.02%. 15 patients (48.38%) with iron deficiency did not have anemia, and 11 (35.5%) of those patients had absolute iron deficiency.

Conclusion: Iron deficiency is prevalent in patients with heart failure and reduced ejection fraction irrespective of anemia and hemoglobin levels. Many of those patients can have functional iron deficiency. Measurement of iron status should be a routine during workup of heart failure patients and further studies are needed to determine the prognostic value of iron status measurement and the influences of treatment of iron deficiency in heart failure patients. Many such trials are now underway.  

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Author Biographies

Aditya Mahaseth, BP Koirala Institute of Health Sciences, Dharan, Nepal

DM Senior Resident, Department of Cardiology

Jay Narayan Shah, BP Koirala Institute of Health Sciences, Dharan, Nepal

House Officer, Department of Cardiology

Bikash Nepal, BP Koirala Institute of Health Sciences, Dharan, Nepal

DM Senior Resident, Department of Cardiology

Biplave Karki, BP Koirala Institute of Health Sciences, Dharan, Nepal

DM Senior Resident, Department of Cardiology

Jeet Ghimire, BP Koirala Institute of Health Sciences, Dharan, Nepal

DM Senior Resident, Department of Cardiology

Naveen Kumar Pandey, BP Koirala Institute of Health Sciences, Dharan, Nepal

Associate Professor, Department of Cardiology

Prashant Shah, BP Koirala Institute of Health Sciences, Dharan, Nepal

Associate Professor, Department of Cardiology

Prahlad Karki, BP Koirala Institute of Health Sciences, Dharan, Nepal

Professor and Head, Department of Cardiology

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Published

2019-12-31

How to Cite

Mahaseth, A., Shah, J. N., Nepal, B., Karki, B., Ghimire, J., Pandey, N. K., Shah, P., & Karki, P. (2019). Prevalence and pattern of Iron deficiency in patient with heart failure with reduced ejection fraction. Janaki Medical College Journal of Medical Science, 7(2), 10–16. https://doi.org/10.3126/jmcjms.v7i2.30689

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Section

Research Articles