Iron deficiency definitions and their clinical and prognostic associations across the spectrum of left ventricular ejection fraction in heart failure

European Journal of Heart Failure 2026 Open access

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Authors: Ridha I S Alnuwaysir, Nils Bömer, Stefan D Anker, Dirk J van Veldhuisen, A W Voors, P. H. Van Der Meer, Niels Grote Beverborg
DOI: 10.1093/ejhf/xuag031
Cited by: 4
References: 30

Abstract

AIMS: Iron deficiency (ID) is prevalent in heart failure (HF). While the impact of ID is well-documented in those with left ventricular ejection fraction (LVEF) < 50 (HFrEF and HFmrEF), its role in those with LVEF ≥50 (HFpEF) is uncertain. We aimed to elucidate and compare the clinical relevance of ID across the LVEF spectrum using multiple definitions. METHODS: Patients with known LVEF and iron parameters from the index and validation cohort of The BIOSTAT-CHF study were pooled (n = 3642). Iron deficiency was defined using three criteria: (i) IDTSAT: transferrin saturation (TSAT) < 20%, (ii) IDSI: serum iron ≤13 μmol/l, and (iii) IDESC: the ESC guideline definition (ferritin

Fields of Study & Subjects

Erythropoietin and Anemia Treatment Heart Failure Treatment and Management Iron Metabolism and Disorders

Publication details

Journal / source
European Journal of Heart Failure
Publisher
Oxford University Press (OUP)
Volume
28
Issue
2
Pages
233–244
Publication date
29 January 2026
Language
EN