Study of Correlation of Iron Profile of Elderly Patients with Heart Failure in a Tertiary Care Center

Abstract

Introduction: Heart failure (HF) and iron deficiency anemia (IDA) are both common in the elderly, especially in India, and the relative paucity of data about the same makes their relationship worthwhile to study. Also, as IDA, especially nutritional, is relatively simple to manage, it can help in reducing disease burden significantly.

Objective: To examine the clinical and etiological profile of patients with HF in the elderly age-group and correlate HF with serum iron, serum ferritin, and percentage transferrin saturation (%TSAT).

Materials and methods: The present prospective, observational sectional study was carried out in a tertiary care hospital, for a duration of 1 year. The study population included 138 elderly patients admitted to medicine wards and intensive care unit (ICU) having HF.

Results: Among the 138 patients with HF included in the study [41.30% in the age-group of 61-65 years, 70.29% males, 35.51% having ejection fraction <30%, 47.83% belonging to New York Heart Association (NYHA) class III], the most frequent clinical symptom among the study subjects was breathlessness (98.55). The most frequent clinical sign was basal lung crepitations (93.48%). The most common etiological factor was ischemic heart disease (56.52%). There were higher serum iron levels and serum %TSAT in patients with better ejection fraction as well as better functional class. No significant association was found between hemoglobin levels and ejection fraction or between hemoglobin levels and NYHA class. There were lower serum ferritin levels in patients with better ejection fraction. No significant association was found between serum ferritin levels and NYHA class. Prevalence of ID was found to be 73.19% in the present study. Absolute and functional ID was reported in 48.55% and 24.64% of the subjects, respectively. Absolute or functional ID had the highest prevalence in subjects having ejection fraction <30% and least in subjects having ejection fraction 45-50% and >50%, which was statistically significant. Absolute or functional ID was revealed maximum in NYHA class IV while it was found least in class I.

Conclusion: ID was associated with severe and more symptomatic HF in the elderly. The results highlight that iron supplementation through diet and medicines will help to decrease mortality, morbidity, and financial burden of the healthcare system.