Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension

Abstract 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...

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Autores principales:	Panagiota Xanthouli, Vivienne Theobald, Nicola Benjamin, Alberto M. Marra, Anna D’Agostino, Benjamin Egenlauf, Memoona Shaukat, Cao Ding, Antonio Cittadini, Eduardo Bossone, Maria Kögler, Ekkehard Grünig, Martina U. Muckenthaler, Christina A. Eichstaedt
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Iron deficiency Anemia Hypochromic erythrocytes Pulmonary arterial hypertension Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/5f874874e5f44b968d11844c35deae0e
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spelling	oai:doaj.org-article:5f874874e5f44b968d11844c35deae0e2021-11-14T12:31:54ZPrognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension10.1186/s12931-021-01884-91465-993Xhttps://doaj.org/article/5f874874e5f44b968d11844c35deae0e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12931-021-01884-9https://doaj.org/toc/1465-993XAbstract 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.Panagiota XanthouliVivienne TheobaldNicola BenjaminAlberto M. MarraAnna D’AgostinoBenjamin EgenlaufMemoona ShaukatCao DingAntonio CittadiniEduardo BossoneMaria KöglerEkkehard GrünigMartina U. MuckenthalerChristina A. EichstaedtBMCarticleIron deficiencyAnemiaHypochromic erythrocytesPulmonary arterial hypertensionDiseases of the respiratory systemRC705-779ENRespiratory Research, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Iron deficiency Anemia Hypochromic erythrocytes Pulmonary arterial hypertension Diseases of the respiratory system RC705-779
spellingShingle	Iron deficiency Anemia Hypochromic erythrocytes Pulmonary arterial hypertension Diseases of the respiratory system RC705-779 Panagiota Xanthouli Vivienne Theobald Nicola Benjamin Alberto M. Marra Anna D’Agostino Benjamin Egenlauf Memoona Shaukat Cao Ding Antonio Cittadini Eduardo Bossone Maria Kögler Ekkehard Grünig Martina U. Muckenthaler Christina A. Eichstaedt Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
description	Abstract 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.
format	article
author	Panagiota Xanthouli Vivienne Theobald Nicola Benjamin Alberto M. Marra Anna D’Agostino Benjamin Egenlauf Memoona Shaukat Cao Ding Antonio Cittadini Eduardo Bossone Maria Kögler Ekkehard Grünig Martina U. Muckenthaler Christina A. Eichstaedt
author_facet	Panagiota Xanthouli Vivienne Theobald Nicola Benjamin Alberto M. Marra Anna D’Agostino Benjamin Egenlauf Memoona Shaukat Cao Ding Antonio Cittadini Eduardo Bossone Maria Kögler Ekkehard Grünig Martina U. Muckenthaler Christina A. Eichstaedt
author_sort	Panagiota Xanthouli
title	Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
title_short	Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
title_full	Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
title_fullStr	Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
title_full_unstemmed	Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
title_sort	prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
publisher	BMC
publishDate	2021
url	https://doaj.org/article/5f874874e5f44b968d11844c35deae0e
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Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension

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