What question did this study set out to answer?

To evaluate the prevalence and classification concordance of iron deficiency in acute versus chronic heart failure using three clinical guideline definitions.

February 11, 2025ESC Heart FailureOpen Access

Prevalence of Iron Deficiency in Acute and Chronic Heart Failure According to Different Clinical Definitions

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Why the study?

Iron deficiency is frequent in acute and chronic heart failure and associated with clinical outcome, but the true prevalence across different clinical definitions needed assessment.

Population

329 AHF and 613 CHF patients at Innsbruck Medical University

Comparison

General definition vs gastroenterology guidelines vs cardiology guidelines for iron deficiency

Design

Retrospective analysis

Authors

LLLukas LanserInnsbruck Medical University GPGerhard PölzlInnsbruck Medical University MMMoritz MessnerInnsbruck Medical University

Discussion

Member takes

Implication

Different ID definitions produce markedly varying prevalence estimates in HF; leaves open optimal criteria for trials and risk stratification.

Key Points

To evaluate the prevalence and classification concordance of iron deficiency in acute versus chronic heart failure using three clinical guideline definitions.
Retrospective analysis of 329 acute heart failure (AHF) and 613 chronic heart failure (CHF) patients treated between February 2021 and May 2022 at Innsbruck Medical University.
Categorized iron deficiency (absolute, combined, and functional) using serum ferritin and transferrin saturation (TSAT) thresholds across general, gastroenterology, and cardiology guideline definitions.
Iron deficiency prevalence was significantly higher in AHF compared to CHF across all definitions: general definition (74.8% vs. 32.6%, P < 0.001), gastroenterology guidelines (75.7% vs. 34.7%, P < 0.001), and cardiology guidelines (79.9% vs. 47.3%, P < 0.001).
Cardiology criteria identified the highest rates of absolute iron deficiency (AHF: 44.7% vs. 20.4% gastro vs. 7.0% general; CHF: 34.1% vs. 13.4% gastro vs. 7.2% general), whereas functional iron deficiency was most prevalent under the general definition (AHF: 34.7% vs. 23.4% gastro vs. 11.6% cardio).
Among 494 patients classified with absolute or combined iron deficiency by cardiology criteria, only 252 retained this classification under the general definition, while 107 were categorized as having no iron deficiency.

Structured PICO

Population

942 patients (329 with acute heart failure [AHF] and 613 with chronic heart failure [CHF]), recruited between 02/2021 and 05/2022 at the Innsbruck Medical University. AHF cohort: 47% female, median age 81 years. CHF cohort: 32% female, median age 64 years.

Outcome

Prevalence of iron deficiency (ID) based on different definitions (general definition, gastroenterology guidelines, and cardiology guidelines)

The prevalence and classification of iron deficiency in heart failure vary significantly depending on the clinical definition applied, highlighting the need for standardized definitions to optimize patient selection for iron supplementation.

Cite This Study

Lanser et al. (2025) studied this question.

synapsesocial.com/papers/6a703eaf26770c2b8de0694b https://doi.org/10.1002/ehf2.15170

Topics

HFrEF treatment Heart failure

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Implication

Different ID definitions produce markedly varying prevalence estimates in HF; leaves open optimal criteria for trials and risk stratification.

Prevalence of Iron Deficiency in Acute and Chronic Heart Failure According to Different Clinical Definitions

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prevalence of Iron Deficiency in Acute and Chronic Heart Failure According to Different Clinical Definitions

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider