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Elevated Ferritin as a Potential Risk Marker for Disease Severity and Prognosis in Heart Failure
Session:
SESSÃO DE POSTERS 43 - INSUFICIÊNCIA CARDÍACA E COMORBILIDADES
Speaker:
José Luís Ferraro
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
José Luís Ferraro; Ana Rodrigo Costa; Mauro Moreira; Inês G. Campos; Rafaela G. Lopes; Joel Ponte Monteiro; Inês Almeida; Carla Almeida; Aurora Andrade
Abstract
<p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Background</strong>: Elevated ferritin levels are associated with systemic inflammation and have been linked to poorer outcomes in heart failure (HF). The aim of this study was to evaluate the association between ferritin levels and disease severity in HF patients.</span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Methods</strong>: A retrospective single-center analysis was conducted including 265 hospitalized HF patients<span style="font-size:11.0pt"><span style="color:black"> throughout 2022</span></span>. This cohort was stratified into two groups based on admission ferritin levels: ferritin >300 ng/mL (n=57) and ferritin ≤300 ng/mL (n=98), excluding those receiving intravenous iron therapy. A statistical analysis was performed to compare baseline characteristics, biomarkers and outcomes between groups. A combined endpoint, which included HF hospitalization, cardiovascular death, all-cause mortality, and unplanned hospital visits, was analyzed. A p-value of <0.05 was considered statistically significant. </span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Results</strong>: 67.9% were male and the mean age was 70.7 ± 12.4 years. The median follow-up period was 1.5 years. Hypertension, diabetes mellitus, dyslipidemia, and chronic renal disease were prevalent, with no significant differences between the groups. Patients with ferritin levels >300 ng/mL had a higher proportion of chronic decompensated HF (71.2% vs. 56.4%, p=0.045), versus new-onset HF. There were no differences between the groups regarding HF etiology. Patients with ferritin levels >300 ng/mL had significantly lower LVEF (30.30% ± 13.45% vs. 36.03% ± 15.82%, p=0.010), higher NT-proBNP levels (13863 ± 1639 pg/mL vs. 8684 ± 714 pg/mL, p 0.004) and lower albumin levels (3.45 ± 0.56 g/dL vs. 3.69 ± 0.44 g/dL, p=0.008). A weak positive correlation was found between ferritin levels and NT-proBNP levels (r = 0.114, p<0.086). Ferritin levels >300 ng/mL was associated with combined endpoint (55.9% vs. 40.7%, p=0.042). Individually, there was an association with cardiovascular death (14 % vs. 5.1%, p=0.043). No significant associations were found for the other variables.</span></span></p> <p style="text-align:justify"><span style="font-family:Verdana,Geneva,sans-serif"><span style="font-size:12pt"><strong>Conclusion</strong>: Elevated ferritin in HF patients is linked to a more severe disease phenotype, characterized by reduced LVEF, elevated NT-proBNP levels, and decreased albumin levels, suggesting a more congestive profile and compromised nutritional status. Higher ferritin levels were more strongly linked to chronic HF and to worse outcomes, particularly increased cardiovascular mortality. These findings highlight the potential of ferritin as an important risk marker in heart failure, warranting further investigation in future studies.</span></span></p>
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