Iron deficiency tied to worse response, remodeling after CRT
Pieter Martens, M.D., from Ziekenhuis Oost-Limburg in Genk, Belgium, and colleagues examined the impact of iron deficiency on clinical response and reverse cardiac remodeling and outcome after CRT in 541 patients with mean follow-up of 38 ± 22 months. The authors assessed New York Heart Association functional class, reverse cardiac remodeling on echocardiography, and clinical outcome retrospectively for patients with full iron status and complete blood count available at implantation.
The researchers found that the prevalence of iron deficiency was 56 percent at implantation. Less symptomatic improvement was seen at six months after implantation for patients with iron deficiency (P < 0.001). Patients with iron deficiency also had significantly lower decrease in left ventricular end-diastolic diameter and improvement in ejection fraction. Irrespective of the presence of anemia, there was a significant association for iron deficiency with an increased risk for heart failure admission or all-cause mortality (adjusted hazard ratio, 1.718).
"In conclusion, iron deficiency is prevalent and affects both clinical response and reverse cardiac remodeling after CRT implantation," the authors write. "Moreover, it is a powerful predictor of adverse clinical outcomes in CRT."
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