BACKGROUND Low transferrin saturation (TSAT) or reduced serum ferritin level are suggestive of iron deficiency but the relationship between iron parameters and outcomes has not been systematically evaluated in older adults with heart failure (HF) and anemia. METHODS We identified a multicenter cohort of adults age ≥ 65 years with HF and incident anemia (hemoglobin <13 g/dL [men] or < 12 g/dL [women]) between 2005 and 2012. Patients were included if ferritin (ng/mL) and TSAT (%) were evaluated within 90 days of incident anemia. HF hospitalizations and all-cause death were ascertained from electronic health records. RESULTS Among 4103 older adults with HF and incident anemia, 47% had TSAT <20% and the median (IQR) ferritin was 126 (53, 256) ng/mL. In multivariable analyses, compared with TSAT ≥20%, patients with TSAT <20% were at increased risk of HF hospitalization for serum ferritin <100 ng/mL (adjusted HR [aHR] 1.40, 95% CI:1.16-1.70) and 100-300 ng/mL (aHR 1.24, 95% CI:1.01-1.52) but not for a ferritin >300 ng/mL (aHR 0.89, 95% CI 0.65-1.23). In addition, TSAT <20% was independently associated with an increased risk of all-cause death regardless of serum ferritin level (<100 ng/mL: aHR 1.42, 95% CI:1.20-1.68; 100-300 ng/mL: aHR 1.18, 95% CI:1.00-1.38; >300 ng/mL: aHR 1.33, 95% CI:1.06-1.69). CONCLUSIONS Among older adults with HF and incident anemia who had iron studies tested, nearly half had a TSAT <20%, which was independently associated with higher rates of morbidity and death.

中文翻译：

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降低的转铁蛋白饱和度与心力衰竭和突发性贫血的老年人的发病率和死亡率过高独立相关。

背景技术低转铁蛋白饱和度（TSAT）或血清铁蛋白水平降低提示铁缺乏，但尚未对患有心力衰竭（HF）和贫血的老年人进行铁参数与预后之间的关系进行系统评估。方法我们确定了2005年至2012年之间患有HF和突发性贫血（血红蛋白<13 g / dL [男性]或<12 g / dL [女性]）的多中心年龄≥65岁的成年人。如果铁蛋白（ng /在发生贫血的90天之内评估了1毫升和TSAT（％）。根据电子健康记录确定了HF住院和全因死亡。结果在4103名患有HF和偶发性贫血的老年人中，47％的TSAT <20％，铁蛋白的中位数（IQR）为126（53，256）ng / mL。在多变量分析中，与TSAT≥20％相比，TSAT < 血清铁蛋白<100 ng / mL（校正后的HR [aHR] 1.40，95％CI：1.16-1.70）和100-300 ng / mL（aHR 1.24，95％CI：1.01-）的20％HF住院风险增加1.52），而不是铁蛋白> 300 ng / mL（aHR 0.89，95％CI 0.65-1.23）。此外，无论血清铁蛋白水平如何，TSAT <20％均与全因死亡风险增加相关（<100 ng / mL：aHR 1.42，95％CI：1.20-1.68； 100-300 ng / mL：aHR 1.18，95％CI：1.00-1.38；> 300 ng / mL：aHR 1.33，95％CI：1.06-1.69）。结论在进行了铁研究的患有HF和偶发性贫血的老年人中，近一半的TSAT <20％，这独立于发病率和死亡率的增加。52），而不是铁蛋白> 300 ng / mL（aHR 0.89，95％CI 0.65-1.23）。此外，无论血清铁蛋白水平如何，TSAT <20％均与全因死亡风险增加相关（<100 ng / mL：aHR 1.42，95％CI：1.20-1.68； 100-300 ng / mL：aHR 1.18，95％CI：1.00-1.38；> 300 ng / mL：aHR 1.33，95％CI：1.06-1.69）。结论在进行了铁研究的患有HF和偶发性贫血的老年人中，近一半的TSAT <20％，这独立于发病率和死亡率的增加。52），而不是铁蛋白> 300 ng / mL（aHR 0.89，95％CI 0.65-1.23）。此外，无论血清铁蛋白水平如何，TSAT <20％均与全因死亡风险增加相关（<100 ng / mL：aHR 1.42，95％CI：1.20-1.68； 100-300 ng / mL：aHR 1.18，95％CI：1.00-1.38；> 300 ng / mL：aHR 1.33，95％CI：1.06-1.69）。结论在进行了铁研究的患有HF和偶发性贫血的老年人中，近一半的TSAT <20％，这独立于发病率和死亡率的增加。