Disordered iron homeostasis among nigerians with chronic heart failure: Pattern, prevalence, and clinical correlates

Abstract

Background: Iron deficiency (ID) often coexists with heart failure and has recently become a therapeutic option in its management. Multiple markers are often required to adequately estimate iron status. This study was aimed at describing the status of iron homeostasis among heart failure patients in Nigeria. Materials and Methods: This was a cross-sectional study done at two tertiary centers in Nigeria. One hundred and forty patients with a diagnosis of heart failure were recruited into the study. Full blood count, total serum iron, total iron-binding capacity, and serum ferritin were measured. Anemia was defined by standardized criteria. Data analysis was done with SPSS 20.0. Results: The mean age of the study patients was 62.96 ± 16.34 years. Disordered iron homeostasis was common, often characterized by predominantly low total serum iron and low transferrin saturation in the presence of normal or high serum ferritin. ID was reported in 60.0% of all patients including 61.3% of anemic and 51.9% of nonanemic patients, P = not significant. High ferritin level was documented in fifty (35.7%) patients (36.8% anemic vs. 32.4% nonanemic patients, P = 0.40). Pulmonary hypertension was more frequent among anemic patients found in 45 patients (including 42.5% of anemic vs. 8.8% of nonanemic patients). ID was associated with poor functional status including ejection fraction, deranged renal function, and advanced disease. Conclusion: Functional ID is very common among heart failure patients in Nigeria irrespective of their anemia status. It is associated with poor functional status and may be a potential therapeutic strategy in Africans with heart failure.