Role of hepcidin in assessing the prognosis of elderly and senile patients with heart failure and anemia
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aim. To study the role of hepcidin in assessing the prognosis of elderly and senile patients with heart failure (HF) and anemia. Material and methods. The study included 105 patients aged 65 to 90 years with NYHA class II‑IV HF of ischemic origin with anemia. Patients were tested for hepcidin and N‑terminal pro‑brain natriuretic peptide (NT‑proBNP) levels once upon admission. Patients were followed up until the primary endpoint of cardiovascular and non‑cardiovascular death for up to 24 months. To assess the effect of hepcidin levels on the risk of death, patients were stratified by quartiles (Q) of hepcidin levels. In each quartile, patients were divided into 2 following groups: with absolute and functional iron deficiency. Cox proportional hazards regression analysis was used to assess the effect of hepcidin levels on the death risk. Results. In patients with HF and anemia, hepcidin levels differed significantly between Q1 and Q4 (p<0,001). Severity of absolute iron deficiency decreased from Q1 to Q4, while the severity of the systemic inflammatory response, on the contrary, increased from Q1 to Q4. During the first 6 months of follow‑up, the highest mortality was found in patients in Q1 (40%), and during 24 months — in patients in Q4 (77%). Regression analysis revealed a significant effect on the death risk of low hepcidin levels (3,0510,33 ng/ml) in patients of Q1 in model 1 (odds ratio (OR) 1,661 (95% confidence interval (CI): 1,198‑2,303), p=0,002), in model 2 (OR 1,911 (95% CI: 1,350‑2,705), p<0,001). There was also a tendency towards a significant effect of elevated hepcidin levels on the death risk (25,81‑70,71 ng/ml) in Q4 patients in model 1 (OR 1,044 (95% CI: 0,997‑1,099), p=0,070), while in model 2, no significant effects on the death risk were found (OR 1,036 (95% CI: 0,989‑1,086), p=0,135). The relationship between hepcidin and the death risk had a U‑shaped curve in both models. Conclusion. To assess the prognosis in elderly and senile patients with HF and anemia, taking into account the identified effect of both low and elevated hepcidin levels on the death risk, hepcidin levels should be determined in addition to NT‑proBNP.
Source: Russian Journal of Cardiology
Institutions: Sechenov University, City Clinical Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415021785