Evidence map›Paper›PMID 32201101›Full record

ArticleInternational journal of cardiology2020

A reduced transferrin saturation is independently associated with excess morbidity and mortality in older adults with heart failure and incident anemia.

Andrew P Ambrosy, Jesse K Fitzpatrick, Grace H Tabada, Jerry H Gurwitz, Andrew Artz, Stanley L Schrier, Sunil V Rao, Kristi Reynolds, David H Smith, Pamela N Peterson and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
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  3. Review
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  5. Article
  6. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 1 country.

Andrew P AmbrosyDivision of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. Electronic address: Andrew.P.Ambrosy@kp.org.
Jesse K FitzpatrickDivision of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA.
Grace H TabadaDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Jerry H GurwitzDivision of Geriatric Medicine, University of Massachusetts Medical School, Worcester, MA, USA; Meyers Primary Care Institute, Worcester, MA, USA.
Andrew ArtzSection of Hematology/Oncology, City of Hope National Medical Center, Duarte, CA, USA.
Stanley L SchrierDivision of Hematology, Stanford University School of Medicine, Stanford, CA, USA.
Sunil V RaoDivision of Cardiology, Duke University Medical Center, Durham, NC, USA; Duke Clinical Research Institute, Duke University Medical School, Durham, NC, USA.
Kristi ReynoldsDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
David H SmithCenter for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Pamela N PetersonInstitute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA; Denver Health Medical Center, Denver, CO, United States of America; University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
Stephen P FortmannKaiser Permanente Center for Health Research, Portland, OR, USA.
Sue Hee SungDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Harvey Jay CohenCenter for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
Alan S GoDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Departments of Epidemiology, Biostatistics and Medicine, University of California at San Francisco, San Francisco, CA, USA; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America.
RBC HEART Investigators/PACTTE Consortium
Kaiser Permanente · USKaiser Permanente Center for Health Research · USKaiser Permanente San Francisco Medical Center · USCity Of Hope National Medical Center · USClinical Research Institute · USDenver Health Medical Center · USDuke Medical Center · USStanford University · USUniversity of Massachusetts Chan Medical School · US

Funding

NHLBI NIH HHS L30 HL133930
6 · The paper itself

Abstract

backgroundLow 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.

methodsWe 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.

resultsAmong 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).

conclusionsAmong 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.

Indexed as

AnemiaAnemia, Iron-DeficiencyHeart FailureAgedFemaleFerritinsHemoglobinsHumansMaleMorbidityTransferrinTransferrinsFerritinsHemoglobinsTransferrinTransferrinsFerritinHeart failureHospitalizationIncident anemiaMortalityOlder adultOutcomeSurvivalTransferrin saturation

Identifiers

PMID32201101
PMCPMC13282765
OpenAlexW3010768198

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.