ArticleClinical research in cardiology : official journal of the German Cardiac Society2024
Ferritin, inflammation, and iron deficiency in acute heart failure: evidence from the EDIFICA cohort.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Prediction of cardiovascular mortality based on iron metabolism in patients with cardiovascular-kidney-metabolic syndrome: development and validation of clinical predictive model.European journal of medical research · 2026Article
- Prognostic Value of Different Iron Status Definitions in Congestive Heart Failure: A Retrospective MIMIC-IV Analysis of Risk Stratification and Mortality.Journal of clinical medicine · 2025Article
- Integrating systemic inflammation and liver biomarkers: prognostic implications of the ferritin index in heart failure.Annals of medicine · 2025Article
- Effect of serum ferritin on the prognosis of patients with coronary heart disease combined with heart failure.BMC cardiovascular disorders · 2025Article
- Prevalence and Prognostic Value of the Novel Consensus Definition of Metabolic Hyperferritinemia in Patients With Heart Failure With Preserved Ejection Fraction Across Different Glucose Metabolism States.Journal of the American Heart Association · 2025Article
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14 authors.
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Abstract
backgroundFerritin is commonly used to evaluate iron stores and guide therapeutic decisions regarding intravenous iron supplementation. However, in the context of AHF, inflammation-driven upregulation of ferritin might disrupt its correlation with iron stores, restricting iron bioavailability and potentially amplifying the inflammatory response.
aimThis study aims to assess the clinical and prognostic associations of ferritin levels in an AHF cohort and to determine whether the prognostic value of ferritin is influenced by the presence of infection, inflammatory activation, and other markers of iron deficiency.
methodsThe association between ferritin and clinical outcomes (180 days) in AHF was evaluated in a cohort of 526 patients from the EDIFICA registry.
resultsThe median ferritin plasma concentration at admission was 180 pg/mL. Patients with higher ferritin levels at admission were predominantly men, exhibiting a high prevalence of chronic kidney disease and alcohol consumption, and presenting with lower blood pressure and a higher incidence of clinical infection. Higher ferritin levels were associated with increased risk of the composite of heart failure hospitalization or cardiovascular death (Tertile 2: HR 1.75; 95% CI 1.10-2.79; p = 0.017; Tertile 3: HR 1.79; 95% CI 1.08-2.97; p = 0.025), independently of classical HF prognostic factors, inflammatory and iron-related markers. No significant associations were found between admission serum iron or transferrin saturation tertiles, iron status categories, or guideline-defined iron deficiency (ID) criteria and the primary composite outcome. However, at discharge, patients who met the criteria for defective iron utilization, low iron storage, or guideline-defined ID had a lower risk of the composite endpoint compared to those with normal iron utilization or who did not meet the guideline-defined ID criteria, respectively.
conclusionsElevated ferritin levels are independently associated with poor prognosis in AHF. Low ferritin levels are associated with a favorable outcome and do not carry significant value in identifying ID in this population.
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