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dc.contributor.authorAlnuwaysir, Ridha I.S.
dc.contributor.authorGrote Beverborg, Niels
dc.contributor.authorHoes, Martijn F.
dc.contributor.authorMarkousis-Mavrogenis, George
dc.contributor.authorGomez, Karla A.
dc.contributor.authorvan der Wal, Haye H.
dc.contributor.authorCleland, John G.
dc.contributor.authorDickstein, Kenneth
dc.contributor.authorLang, Chim C.
dc.contributor.authorNg, Leong L.
dc.contributor.authorPonikowski, Piotr
dc.contributor.authorAnker, Stefan D.
dc.contributor.authorvan Veldhuisen, Dirk J.
dc.contributor.authorVoors, Adriaan A.
dc.contributor.authorvan der Meer, Peter
dc.description.abstractAims Whereas the combination of anaemia and chronic kidney disease (CKD) has been extensively studied in patients with heart failure (HF), the contribution of iron deficiency (ID) to this dysfunctional interplay is unknown. We aimed to assess clinical associates and pathophysiological pathways related to ID in this multimorbid syndrome. Methods and results We studied 2151 patients with HF from the BIOSTAT-CHF cohort. Patients were stratified based on ID (transferrin saturation <20%), anaemia (World Health Organization definition) and/or CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2). Patients were mainly men (73.3%), with a median age of 70.5 (interquartile range 61.4–78.1). ID was more prevalent than CKD and anaemia (63.3%, 47.2% and 35.6% respectively), with highest prevalence in those with concomitant CKD and anaemia (77.5% vs. 59.3%; p < 0.001). There was a considerable overlap in biomarkers and pathways between patients with isolated ID, anaemia or CKD, or in combination, with processes related to immunity, inflammation, cell survival and cancer amongst the common pathways. Key biomarkers shared between syndromes with ID included transferrin receptor, interleukin-6, fibroblast growth factor-23, and bone morphogenetic protein 6. Having ID, either alone or on top of anaemia and/or CKD, was associated with a lower overall summary Kansas City Cardiomyopathy Questionnaire score, an impaired 6-min walk test and increased incidence of hospitalizations and/or mortality in multivariable analyses (all p < 0.05). Conclusion Iron deficiency, CKD and/or anaemia in patients with HF have great overlap in biomarker profiles, suggesting common pathways associated with these syndromes. ID either alone or on top of CKD and anaemia is associated with worse quality of life, exercise capacity and prognosis of patients with worsening HF.en_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.titleAdditional burden of iron deficiency in heart failure patients beyond the cardio-renal anaemia syndrome: findings from the BIOSTAT-CHF studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.source.journalEuropean Journal of Heart Failureen_US
dc.identifier.citationEuropean Journal of Heart Failure. 2022, 24(1), 192-204.en_US

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Navngivelse-Ikkekommersiell 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse-Ikkekommersiell 4.0 Internasjonal