Key result
A decrease in reticulocyte hemoglobin equivalent of 2 pg or more between admission and discharge was associated with a significantly higher risk of all-cause death or heart failure readmission (HR 2.32).
Why the study?
Current diagnostic markers for iron deficiency in heart failure have limitations, and the clinical utility of reticulocyte hemoglobin equivalent remains uncertain.
Does reticulocyte hemoglobin equivalent (Ret-He) predict outcomes or identify iron deficiency in patients hospitalized for decompensated heart failure?
Cohort (n=142)
No
Does reticulocyte hemoglobin equivalent (Ret-He) predict outcomes or identify iron deficiency in patients hospitalized for decompensated heart failure?
Hazard Ratio: 2.32 (95% CI 1.15–4.68)
p-value: p=0.019
Ret-He correlates with traditional iron markers in decompensated HF, but its prognostic utility requires further investigation as both increases and decreases during hospitalization were associated with worse outcomes.
Anemia and iron deficiency (ID) are common in patients with heart failure (HF) and intravenous (IV) administration of iron to patients hospitalized for decompensated HF with ID improves outcome. The diagnosis of ID in routine practice is based on serum ferritin and transferrin saturation (TSAT) but both have limitations; alternatives should be considered. Reticulocyte hemoglobin equivalent (Ret-He) reflects iron content in reticulocytes but its clinical utility in patients with HF remains uncertain. We prospectively enrolled 142 patients hospitalized for decompensated HF. Sixty five percent had ID as defined in current international guidelines. Ret-He was directly correlated with serum iron and ferritin concentrations and with TSAT. There was a poor relationship between quartile of Ret-He and HF hospitalization or death but increases or decreases in Ret-He between admission and discharge were associated with a worse outcome. The clinical utility of Ret-He for identifying ID and predicting response to IV iron and prognosis for patients with HF requires further investigation.
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Tahara et al. (2022) conducted a cohort in Acute decompensated heart failure (n=142). Decrease in reticulocyte hemoglobin equivalent (ΔRet-He ≤ -2 pg) vs. Change in Ret-He > -2 pg was evaluated on Composite of all-cause death or heart failure readmission (HR 2.32, 95% CI 1.15-4.68, p=0.019). A decrease in reticulocyte hemoglobin equivalent of 2 pg or more between admission and discharge was associated with a significantly higher risk of all-cause death or heart failure readmission (HR 2.32).
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