Prognostic role of tissue iron deficiency measured by sTfR levels in heart failure patients without systemic iron deficiency or anemia

Background: Iron deficiency (ID) is a significant, high-prevalence comorbidity in chronic heart failure (HF) that represents an independent predictor of a worse prognosis. However, a clear-cut diagnosis of ID in HF patients is not assured. The soluble transferrin receptor (sTfR) is a marker that ref...

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Detalles Bibliográficos
Autores: Jovells i Vaquer, Sílvia, Ramos Polo, Raúl, Ras Jiménez, Maria del Mar, Francesch Manzano, Josep, Morillas Climent, Herminio, Pons Riverola, Alexandra, Yun Viladomat, Sergi, Moliner Borja, Pedro, González Costello, José, García Romero, Elena, Herrador Galindo, Lorena, Frutos Seminario, Fernando de, Enjuanes, Cristina, Tajes Orduña, Marta, Comín Colet, Josep, Diez Lopez, Carles
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/215710
Acceso en línea:https://hdl.handle.net/2445/215710
Access Level:acceso abierto
Palabra clave:Dèficit de ferro
Insuficiència cardíaca
Marcadors bioquímics
Iron deficiency diseases
Heart failure
Biochemical markers
Descripción
Sumario:Background: Iron deficiency (ID) is a significant, high-prevalence comorbidity in chronic heart failure (HF) that represents an independent predictor of a worse prognosis. However, a clear-cut diagnosis of ID in HF patients is not assured. The soluble transferrin receptor (sTfR) is a marker that reflects tissue-level iron demand and may be an early marker of ID. However, the impact of sTfR levels on clinical outcomes in non-anemic HF patients with a normal systemic iron status has never been evaluated. Methods: This is a post hoc analysis of an observational, prospective cohort study of 1236 patients with chronic HF of which only those with normal hemoglobin levels and a normal systemic iron status were studied. The final cohort consisted of 215 patients. Tissue ID was defined as levels of sTfR > 75th percentile (1.65 mg/L). Our aim was to describe the association between sTfR and clinical outcomes (all-cause death and HF hospitalization) and to explore its association with a wide array of serum biomarkers. Results: The sTfR level (HR 1.48, 95% CI 1.13-1.96, p = 0.005) and tissue ID (HR 2.14, 95% CI 1.22-3.75, p = 0.008) was associated with all-cause death. However, we found no association between sTfR levels and the risk of HF hospitalization. Furthermore, high sTfR levels were associated with a worse biomarker profile indicating myocardial damage (troponin and NT-proBNP), systemic inflammation (CRP and albumin), and impaired erythropoiesis (erythropoietin). Conclusions: In this cohort, the presence of tissue ID defined by sTfR levels is an independent factor for all-cause death in patients with normal systemic iron parameters.

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