Iron deficiency and heart failure: assessment of the burden, clinical and hospital impact at the National Institute of Cardiology

Abstract

Introduction: Iron deficiency, with or without associated anemia, is a common comorbidity in heart failure.

Objective: To determine the frequency of iron deficiency in patients hospitalized for heart failure at the National Institute of Cardiology between May and December 2024 and to evaluate its relationship with disease severity, clinical outcomes, and hospital indicators.

Methodology: Descriptive, correlational, prospective study. Patients of both sexes, over 18 years of age, hospitalized for heart failure were included. Demographic and clinical data, comorbidities, laboratory parameters (serum iron, ferritin, transferrin saturation), renal function, functional class (NYHA), ejection fraction, hospital stay, and in-hospital mortality were collected. Iron deficiency was established in all patients with serum iron < 50 mcg/dL and ferritin < 100 ng/mL

Results: Seventy six patients hospitalized for heart failure (mean age 63 years; 75% men) were studied. Iron deficiency was common (72.4%), especially in those over 60 years of age (OR=6.0; p=0.002) and with multiple cardiovascular risk factors (p<0.005). There was no significant association with ejection fraction or etiology. Iron deficiency was observed in 53.3% of patients with anemia and 53.6% without anemia. According to renal function, the frequency was 60% in GFR <45 mL/min. Functional class was significantly associated with iron deficiency (p=0.001). Mortality was higher in the iron deficiency group (17.1%), without statistical significance.

Conclusion: Iron deficiency is highly prevalent in patients hospitalized for heart failure and is associated with a worse clinical profile. Its detection and correction should be integrated into management to optimize patient outcome and prognosis.