Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5 |
||
Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension | ||
C. Eichstaedt1, V. Theobald2, P. Xanthouli2, N. Benjamin2, A. M. Marra3, A. D'Agostino3, B. Egenlauf2, M. Shaukat2, C. Ding2, A. Cittadini3, E. Bossone4, M. Kögler1, E. Grünig1, M. Muckenthaler5 | ||
1Thoraxklinik, Universitätsklinikum Heidelberg, Heidelberg; 2Pneumologie und Beatmungsmedizin / Zentrum für Pulmonale Hypertonie, Thoraxklinik - Heidelberg gGmbH, Heidelberg; 3Department of Translational Medical Sciences, "Federico II" University of Naples, Neapel, IT; 4Cardiology Department, Antonio Cardarelli Hospital, Naples, Neapel, IT; 5Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Molecular Medicine Partnership Unit (MMPU), EMBL und Universität Heidelberg, Heidelberg; | ||
Background: Iron deficiency affects up to 50% of patients with pulmonary arterial hypertension (PAH) but iron markers such as ferritin and serum iron are confounded by several non-disease related factors like acute inflammation and diet. The aim of this study was to identify a new marker for iron deficiency and clinical outcome in PAH patients. Methods: In this single-center, retrospective study we assessed indicators of iron status and clinical parameters specifying the time to clinical worsening (TTCW) and survival in PAH patients at time of initial diagnosis and at 1-year follow-up using univariable and multivariable analysis. Results: In total, 150 patients were included with an invasively confirmed PAH and complete data on iron metabolism. The proportion of hypochromic erythrocytes >2% at initial diagnosis was identified as an independent predictor for a shorter TTCW (p=0.0001) and worse survival (p=0.002) at initial diagnosis as well as worse survival (p=0.016) at 1-year follow-up. Only a subset of these patients (64%) suffered from iron deficiency. Low ferritin or low serum iron neither correlated with TTCW nor survival. Severe hemoglobin deficiency at baseline was significantly associated with a shorter TTCW (p=0.001). Conclusions: The presence of hypochromic erythrocytes >2% was a strong and independent predictor of mortality and shorter TTCW in this cohort of PAH patients. Thus, it can serve as a valuable indicator of iron homeostasis and prognosis even in patients without iron deficiency or anemia. Further studies are needed to confirm the results and to investigate therapeutic implications. |
||
https://dgk.org/kongress_programme/jt2022/aP892.html |