15 Serum ferritin, TSAT, and serum iron were used as biomarkers of ID. Patients with an LVEF >40% who had no available measurement of NT-proBNP or an NT-proBNP<125 ng/L or lacked echocardiographic data were excluded from this analysis.Īnemia was defined according to World Health Organization criteria as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men. If NT-proBNP was high but information on LV function was not available, patients were grouped as HF-↑NT-proBNP. Those with an NT-proBNP ≥125 ng/L and an LVEF >40% were further classified as those with HF with an LVEF in the mid-range (HF with mid-range EF: LVEF 40%-49% or mild or mild-moderate LVSD) or preserved (HF with preserved EF : LVEF ≥50% or trivial or no LVSD). HF was defined by the presence of symptoms and signs of HF and either 1) a left ventricular ejection fraction (LVEF) ≤40% (HF with reduced EF or moderate or severe LV systolic dysfunction ) or 2) a plasma NT-proBNP ≥125 ng/L. 10-14Īccordingly, we investigated the prevalence, associations, and prognostic significance of ID using diverse criteria in a large cohort of patients attending an HF clinic. 10 Observational studies suggest that serum iron concentration and TSAT might both be more strongly associated with prognosis than serum ferritin and might be a better guide to which patients benefit from IV iron. 9 Bone marrow biopsy, the gold-standard for diagnosing ID, may demonstrate ID even when ferritin is high. Any cell damage, including activation of inflammatory pathways, may cause ferritin to be released an increase in serum ferritin may occur even in the presence of ID. #IRON STUDIES INTERPRETATION FREE#Most ferritin resides in cells where it binds to iron to prevent free radical production. 8 However, a definition based primarily on ferritin has several limitations. 5, 6 These criteria were based on a consensus of opinion mainly among nephrologists 7 and on the selection criteria for successful clinical trials of intravenous (IV) iron in HF, such as the FAIR-HF (Ferric Carboxymaltose in Patients with Heart Failure and Iron Deficiency) trial. However, international guidelines on HF define ID as a serum ferritin <100 ng/mL or, when ferritin is 100-299 ng/mL, a transferrin saturation (TSAT) <20%. The World Health Organization defines ID as a serum ferritin <15 ng/mL, and most clinical laboratories define ID as <30 ng/mL. 1–4 Many definitions of ID have been proposed, but consensus is lacking on which should be used in clinical practice for patients with HF. This will help in making the appropriate treatment recommendations.Iron deficiency (ID), inferred from the results of blood tests, is common in chronic heart failure (HF) and, in the presence or absence of anemia, is associated with poorer quality of life, exercise capacity, and prognosis. If your iron studies come back too low or too high, your health care provider may recommend additional testing to specifically determine the source of the problem. Results that lie above 176 µg/dL for men and 170 µg/dL for women may indicate the presence of iron overload, or hemochromatosis. Results below 65 µg/dL for men and 50 µg/dL for women may indicate the presence of anemia. While certain individuals may consistently have readings slightly outside of these ranges with no problems, any changes in the patient’s normal results can indicate a potential problem. For women, the range averages from 50 to 170 µg/dL. For men, the average range is approximately 65 to 176 µg/dL. Serum iron ranges vary between men and women. Because iron levels are generally higher in the morning, your health care provider may request that you make an early appointment to get the appropriate results. In most cases, your physician will recommend that you fast for at least 12 hours before having the test. This simple blood test can be performed in the office or at a lab. Too little or too much iron in the body can lead to additional health problems. This helps your physician to make a proper diagnosis so that effective treatment options can be provided. In addition to indications observed in the results of other tests, your health care provider may request iron studies if you exhibit symptoms associated with low or high iron. An iron test is not performed routinely but is often recommended if other blood tests, such as a complete blood count, a hemoglobin, or a hematocrit test, indicate a potential problem. This test can help to determine if your iron is too low or too high. An iron studies test is a blood test that is used to determine the amount of iron in your body.
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