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Iron Deficiency in ...
Iron Deficiency in Heart Failure and Effect of Dapagliflozin : Findings From DAPA-HF.
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Docherty, Kieran F. (author)
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Welsh, Paul (author)
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Verma, Subodh (author)
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De Boer, Rudolf A. (author)
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O’Meara, Eileen (author)
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Bengtsson, Olof (author)
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Kober, Lars (author)
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Kosiborod, Mikhail N. (author)
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Hammarstedt, Ann (author)
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Langkilde, Anna Maria (author)
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Lindholm, Daniel (author)
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Little, Dustin J. (author)
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Sjostrand, Mikaela (author)
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Martinez, Felipe A. (author)
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Ponikowski, Piotr (author)
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Sabatine, Marc S. (author)
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Morrow, David A. (author)
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Schou, Morten (author)
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Solomon, Scott D. (author)
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Sattar, Naveed (author)
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Jhund, Pardeep S. (author)
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McMurray, John J. V. (author)
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- 2022
- 2022
- English.
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In: Circulation. ; 146:13, s. 980-994
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Iron deficiency is common in heart failure and associated with worse outcomes. We examined the prevalence and consequences of iron deficiency in the DAPA-HF trial (Dapagliflozin and Prevention of Adverse- Outcomes in Heart Failure) and the effect of dapagliflozin on markers of iron metabolism. We also analyzed the effect of dapagliflozin on outcomes, according to iron status at baseline. METHODS: Iron deficiency was defined as a ferritin level $<$100 ng/mL or a transferrin saturation $<$20% and a ferritin level 100 to 299 ng/mL. Additional biomarkers of iron metabolism, including soluble transferrin receptor, erythropoietin, and hepcidin were measured at baseline and 12 months after randomization. The primary outcome was a composite of worsening heart failure (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death. RESULTS: Of the 4744 patients randomized in DAPA- HF, 3009 had ferritin and transferrin saturation measurements available at baseline, and 1314 of these participants (43.7%) were iron deficient. The rate of the primary outcome was higher in patients with iron deficiency (16.6 per 100 person-years) compared with those without (10.4 per 100 person-years; P$<$0.0001). The effect of dapagliflozin on the primary outcome was consistent in iron-deficient compared with iron- replete patients (hazard ratio, 0.74 [95% CI, 0.58-0.92] versus 0.81 [95% CI, 0.63-1.03]; P-interaction=0.59). Similar findings were observed for cardiovascular death, heart failure hospitalization, and all-cause mortality. Transferrin saturation, ferritin, and hepcidin were reduced and total iron-binding capacity and soluble transferrin receptor increased with dapagliflozin compared with placebo. CONCLUSIONS: Iron deficiency was common in DAPA-HF and associated with worse outcomes. Dapagliflozin appeared to increase iron use but improved outcomes, irrespective of iron status at baseline. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03036124.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- *Heart Failure/complications/drug therapy/epidemiology
- *Iron Deficiencies
- anemia
- Benzhydryl Compounds
- Biomarkers
- erythropoiesis
- ferritin
- Ferritins
- Glucosides
- heart failure
- hepcidin
- Hepcidins
- Humans
- iron
- Iron
- Receptors
- Erythropoietin/therapeutic use
- Receptors
- Transferrin
- sodium-glucose cotransporter 2 inhibitor
- Stroke Volume
- transferrin
- Transferrins/pharmacology/therapeutic use
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Docherty, Kieran ...
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Welsh, Paul
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Verma, Subodh
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De Boer, Rudolf ...
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O’Meara, Eileen
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Bengtsson, Olof
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show more...
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Kober, Lars
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Kosiborod, Mikha ...
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Hammarstedt, Ann
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Langkilde, Anna ...
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Lindholm, Daniel
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Little, Dustin J ...
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Sjostrand, Mikae ...
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Martinez, Felipe ...
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Ponikowski, Piot ...
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Sabatine, Marc S ...
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Morrow, David A.
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Schou, Morten
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Solomon, Scott D ...
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Sattar, Naveed
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Jhund, Pardeep S ...
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McMurray, John J ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
- Circulation
- By the university
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Uppsala University