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Iron Deficiency and Incident Heart Failure in Older Community-Dwelling Individuals.

TitleIron Deficiency and Incident Heart Failure in Older Community-Dwelling Individuals.
Publication TypeJournal Article
Year of Publication2024
AuthorsSharma, S, Katz, R, Chaves, PHM, Hoofnagle, AN, Kizer, JR, Bansal, N, Ganz, T, Ix, JH
JournalESC Heart Fail
Date Published2024 Feb 26
ISSN2055-5822
Abstract<p><b>AIMS: </b>Among persons with prevalent heart failure (HF), iron deficiency has been linked to HF admissions, and intravenous iron replacement improves HF outcomes. Recent studies in persons with chronic kidney disease (CKD) demonstrate that iron deficiency is associated with incident HF. This study aimed to determine the relationship of iron status with incident HF in community-dwelling older adults irrespective of their kidney function.</p><p><b>METHODS: </b>In this case-cohort study, 1,006 Cardiovascular Health Study participants (785 from the random sub-cohort [including 193 HF cases] and 221 additional HF cases [N = 414 total HF cases]) aged ≥ 65 years without HF (41% with CKD), we used weighted Cox models to evaluate associations of iron status with incident HF. Participants were categorized based on quartiles of transferrin saturation and ferritin as "iron replete" (27.3%), "functional iron deficiency" (7.7%), "iron deficiency" (11.8%), "mixed iron deficiency" (5.6%), "high iron" (9.3%) and "non-classified" (38.1%), consistent with prior studies.</p><p><b>RESULTS: </b>Compared to older persons who were iron replete, those with iron deficiency were at higher risk of incident HF (HR 1.47; 1.02-2.11) in models adjusting for demographics, HF risk factors, and estimated glomerular filtration rate. Other iron categories did not associate with incident HF. The relationship of iron deficiency with incident HF did not differ by CKD status (interaction P value 0.2).</p><p><b>CONCLUSIONS: </b>Among community-dwelling elders, iron deficiency is independently associated with incident HF, an association that was similar irrespective of CKD status. Our findings support conduct of clinical trials of iron replacement for prevention of HF in older adults with iron deficiency.</p>
DOI10.1002/ehf2.14724
Alternate JournalESC Heart Fail
PubMed ID38407565
Grant ListR01DK119528 / / National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) /
K24DK110427 / / National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) /
IK2-CX002195 / / Veterans' Health Administration /
U01HL080295 / / National Heart, Lung, and Blood Institute (NHLBI) /
U01HL130114 / / National Heart, Lung, and Blood Institute (NHLBI) /
/ / National Institute of Neurological Disorders and Stroke (NINDS) /
R01AG023629 / / National Institute on Aging (NIA) /
ePub date: 
24/02