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Kvaslerud AB, Hussain AI, Auensen A, et al. Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis. Open Heart. 2018;5(2):e000901doi: 10.1136/openhrt-2018-000901.
Kvaslerud, A. B., Hussain, A. I., Auensen, A., Ueland, T., Michelsen, A. E., Pettersen, K. I., Aukrust, P., Mørkrid, L., Gullestad, L., & Broch, K. (2018). Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis. Open heart, 5(2), e000901. https://doi.org/10.1136/openhrt-2018-000901
Kvaslerud, Anette Borger, et al. "Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis." Open heart vol. 5,2 (2018): e000901. doi: https://doi.org/10.1136/openhrt-2018-000901
Kvaslerud AB, Hussain AI, Auensen A, Ueland T, Michelsen AE, Pettersen KI, Aukrust P, Mørkrid L, Gullestad L, Broch K. Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis. Open Heart. 2018 Dec 16;5(2):e000901. doi: 10.1136/openhrt-2018-000901. eCollection 2018. PMID: 30613413; PMCID: PMC6307621.
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Open Heart. 2018 Dec 16;5(2):e000901. doi: 10.1136/openhrt-2018-000901. eCollection 2018.

Prevalence and prognostic implication of iron deficiency and anaemia in patients with severe aortic stenosis.

Open heart

Anette Borger Kvaslerud, Amjad Iqbal Hussain, Andreas Auensen, Thor Ueland, Annika E Michelsen, Kjell Ingar Pettersen, Pål Aukrust, Lars Mørkrid, Lars Gullestad, Kaspar Broch

Affiliations

  1. Faculty of Medicine, University of Oslo, Oslo, Norway.
  2. KG Jebsen Centre for Cardiac Research and Center for Heart Failure Research, Oslo University Hospital Ullevål, Oslo, Norway.
  3. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
  4. Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
  5. K.G. Jebsen - Thrombosis Research and Expertise Center (TREC), The Faculty of Health Sciences, UT - The Arctic University of Norway, Tromsø, Norway.
  6. Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
  7. Department of Medical Biochemistry, Oslo University Hospital Rikshospitalet, Oslo, Norway.

PMID: 30613413 PMCID: PMC6307621 DOI: 10.1136/openhrt-2018-000901

Abstract

OBJECTIVE: The aim of this study was to evaluate the prevalence and prognostic implication of iron deficiency (ID) and anaemia in patients with severe aortic stenosis (AS).

METHODS: In an observational study of consecutive patients referred for aortic valve replacement (AVR), we assessed a wide range of biomarkers of iron status, including the definition of ID commonly applied in patients with chronic heart failure (ferritin <100 µg/L or ferritin 100-299 µg/L with a transferrin saturation <20%). The endpoints were short-term (one-year) and long-term (median 4.7 years, IQR: 3.8-5.5) mortality and major adverse cardiovascular events (MACE) within the first year after inclusion.

RESULTS: 464 patients were included in this substudy. 91 patients (20%) received conservative treatment and 373 patients (80%) received AVR. ID was detected in 246 patients (53%). 94 patients (20%) had anaemia. Patients with ID had an overall worse clinical profile than patients without ID. During follow-up, 129 patients (28%) died. Neither ID as defined above, soluble transferrin receptor nor hepcidin were associated with short-term or long-term mortality or MACE independent on treatment allocation. Anaemia was associated with one-year mortality in conservatively treated patients.

CONCLUSIONS: ID and anaemia are prevalent in patients with severe AS. In our cohort, ID did not provide independent prognostic information on top of conventional risk factors. More studies are required to determine how to correctly diagnose ID in patients with AS.

TRIAL REGISTRATION NUMBER: NCT01794832.

Keywords: anaemia; aortic valve disease; epidemiology; iron deficiency; prosthetic heart valves

Conflict of interest statement

Competing interests: None declared.

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