SPC365

Iron Status Variation In Acute Heart Failure: A Prospective Study - Release Of Preliminary Data

Session: Posters (Sessão 5 - Écran 4) - Insuficiência Cardíaca 5 - Marcadores Serológicos
Speaker: Gonçalo da Fonseca Durão Carvalho

Congress: CPC 2022
Topic: D. Heart Failure
Theme: 11. Acute Heart Failure
Subtheme: 11.3 Acute Heart Failure – Diagnostic Methods
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Goncalo Durao-Carvalho; André Maia; Margarida Pimentel Nunes; Ana Lopes Dos Santos; Anabela de Carvalho; Hugo Raposo Inácio; Joana Gamelas de Carvalho; Bruno Rocha; Gonçalo Cunha; Joana Duarte; Catarina Rodrigues; Célia Henriques; Inês Fornelos Araújo; Cândida Fonseca

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Iron deficiency (ID) is a frequent comorbidity in Heart Failure (HF) with symptomatic and prognostic impact and can be assessed through biomarkers, such as ferritin and transferrin saturation (TSAT). Due to the proinflammatory state characteristic of HF, ferritin cutoffs used to define ID are higher (absolute ID [AID] &lt;100ng/mL or functional ID [FID] 100-299ng/mL and TSAT &lt;20%) than in other conditions. In acute and frequently congestive HF, the optimal timing for biomarkers assessment and ID correction is not known. To address this gap in evidence, we performed a pilot study aiming to compare the Iron Status (IS) of patients at admission and at hospital discharge. The preliminary results are shown. </span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">A prospective observational study of patients admitted to an HF unit between August-October 2018 and June-November 2021 was done. Their IS at admission&nbsp;and&nbsp;discharge (after decongestion) was compared. Out of 98 eligible patients, we excluded those without the complete blood workup (n=27), those who received ferric&nbsp;carboxymaltose (FCM) (n=13) or blood transfusions (n=8) between admission and discharge workup, those who died (n=5), disease states which might influence IS or hemoglobin level (2 with an active infection at discharge, 1 with polycythemia), or therapy with oral iron before admission (n=1).</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Regarding the included patients, 44% were women, median age was 76 years</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"> [63.5; 82] </span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">and median length of hospital stay was 7 days </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">[5; 12]. </span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">Left </span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">ventricle ejection fraction was reduced in 46%, preserved in 44%, improved in 5% and mildly reduced in 5%. Comparing IS at&nbsp;admission and discharge, absence of ID was verified in 44% vs. 68% of patients, FID in 39% vs. 20%, and AID in 17% vs. 12%. Specifically, 26 patients (64%) maintained their IS; 9 (22%) with FID and 3 (7%) with AID were no longer iron deficient; 2 (5%) without ID developed FID; one patient (2%) changed from FID to AID. Comparing median admis</span>sion and discharge values, hemoglobin was 12.6g/dL (vs. 12.5g/dL, &Delta;=0), ferritin was 237ng/mL (vs. 268ng/mL, &Delta;=+9), TSAT 18% (vs. 24%, &Delta;=+5, Wilcoxon Signed Rank Test p=0.001). In addition, the median accumulated fluid balance was -820mL [-4650; 707.5], and median &Delta;NT-proBNP was -2049pg/mL [-6275; -290].</span></span></span></p>

<p><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">The transition from hypervolemia to euvolemia appears to parallel an improvement&nbsp; in&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">IS. Thus, the decision to prescribe FCM could be deferred until patient iron&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">status is reevaluated at discharge, in order to avoid unnecessary&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000">administrations.</span></span></span></p>