Ferritin and Prognosis in Elderly Patients with Heart Failure and Preserved Ejection Fraction

Background: Iron deficiency (ID) and anaemia are frequent in Heart Failure (HF) patients, but there are few data about its prevalence and prognosis in elderly HF patients with preserved ejection fraction (HF-PEF). Aim: The aim of this study is to ascertain if ID alone or associated with anaemia is related to negative clinical outcomes in elderly patients with HF-PEF. Design/Methods: 139 consecutive patients discharged from our Internal Medicine Department with a diagnosis of HF-PEF from June 2011 to June 2014 were followed up until June 2015. All demographic and clinical data, echocardiography, biochemical parameters, treatment at discharge, new hospital admissions and death were registered in a specific database. Results: Mean age was 79.1 years (SD 8.3 years), and 94 (67.6%) were women. Anaemia was present in 85 (61%), any iron deficiency in 92 (67%) and absolute iron deficiency in 67 (48%) of these patients. 33 patients (23%) died during a mean follow-up of 649 days. Increased mortality was related to age, previous hospital admissions, lower albumin level, lower Barthel score, and higher ferritin level. Using a composite endpoint of HF readmission or death during first year after index admission, 54 patients (38.8%) had this negative outcome. Lower Barthel Score and albumin values, higher NT pro-BNP and ferritin level, and absence of iron deficiency, were related to this negative outcome. Conclusion: Anaemia and Iron Deficiency are usual findings in our elderly HF-PEF patients, but only a high level of serum ferritin was associated with worse outcomes in this setting.