Prevalence and spectrum of iron deficiency in heart failure patients in south Rajasthan.

Objective: To estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) patients with or without anemia.

Methods: This is a single-center observational study, conducted at a tertiary care hospital of south Rajasthan. Patients admitted to hospital with clinical diagnosis of HF based on validated clinical criteria were included in the study. ID was diagnosed based on complete Iron profile, including serum iron, serum ferritin, total iron binding capacity, and transferrin saturation (TSAT). Anemia was defined as hemoglobin (Hb) <13g/dl for males and <12g/dl for females, based on World Health Organization definition. Absolute ID was taken as serum ferritin<100μg/L and functional ID was defined as normal serum ferritin (100-300μg/L) with low TSAT (<20%).

Results: A total of 150 patients of HF (68% males and 32% females) were studied. Most of the patients were of high-functional NYHA class (mean NYHA 2.89±0.95). ID was present in 76% patients with 48.7% patients having absolute and 27.3% patients having functional ID. Females were having significantly higher prevalence of ID than males (91.6% vs 68.6%; p=0.002). Nearly one-fourth of the patients were having ID but without anemia, signifying importance of workup of ID other than Hb.

Conclusion: Our study highlights the yet underestimated and neglected burden of ID in HF patients in India. This study suggests further large-scale studies to better characterize this easily treatable condition and considering routine testing in future Indian guidelines.