Key result
TSAT <20% independently increased 12-month adverse heart failure outcomes, while hemoglobin's prognostic effect varied by renal function.
Why the study?
Anemia and iron deficiency are highly prevalent in patients hospitalized for heart failure, yet their prognostic contributions in the acute setting across kidney function remain incompletely understood.
Does the presence of anemia, low transferrin saturation (TSAT), and iron deficiency across varying kidney function predict 12-month postdischarge outcomes in patients hospitalized for heart failure?
Cohort
Does the presence of anemia, low transferrin saturation (TSAT), and iron deficiency across varying kidney function predict 12-month postdischarge outcomes in patients hospitalized for heart failure?
In patients hospitalized for heart failure, the prognostic impact of anemia depends on renal function, while a transferrin saturation (TSAT) <20% is the only iron deficiency definition independently predictive of 12-month adverse outcomes.
Answers are grounded in this paper and cite their sources.
Lower hemoglobin at discharge identifies higher-risk HF patients; extends prognostic data but leaves open targeted interventions by renal function.
BACKGROUND: Anemia and iron deficiency (ID) are highly prevalent among patients hospitalized for heart failure (HHF). Their prognostic contributions in the acute setting, particularly across kidney function, remain incompletely understood. OBJECTIVES: We investigated the association of anemia, transferrin saturation (TSAT), and ID according to kidney function, with postdischarge outcomes in HHF patients. METHODS: Consecutive HHF patients enrolled in the OPPORTUNITIES registry with available hemoglobin and TSAT at discharge. The primary endpoint was HF-free survival, a composite of all-cause death, urgent heart transplantation, heart failure (HF) hospitalization, and urgent emergency department referral for HF worsening at 12 months. Adjusted Cox regression models were applied. Lower hemoglobin was independently associated with a higher risk (adjusted HR: 0.82; 95% CI: 0.75-0.91; P < 0.001), whereas TSAT was not independently predictive. A significant interaction between hemoglobin and renal function was observed (P = 0.025), indicating that the hemoglobin effect varied according to kidney function. Among ID definitions, only TSAT <20% independently identified patients at an increased risk (HR: 1.44; 95% CI: 1.03-2.03; P = 0.035). CONCLUSIONS: In HHF patients, the prognostic relevance of anemia varies according to renal function. TSAT <20% was the only ID definition independently associated with adverse outcomes.
No takes yet. Share an insight, caveat, or question.
Fazzini et al. (2026) conducted a cohort in Hospitalized heart failure. Anemia, transferrin saturation (TSAT), and iron deficiency across renal function vs. Normal hemoglobin or TSAT >=20% was evaluated on HF-free survival (composite of all-cause death, urgent heart transplantation, heart failure hospitalization, and urgent emergency department referral for HF worsening at 12 months) (HR 1.44, 95% CI 1.03-2.03, p=0.035). TSAT <20% independently increased 12-month adverse heart failure outcomes, while hemoglobin's prognostic effect varied by renal function.
Synapse has enriched 10 related papers. Consider them for comparative context: