{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:03:26Z","timestamp":1785542606279,"version":"3.56.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1389,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:00:00Z","timestamp":1644883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"IQVIA Operations France"},{"name":"Vifor Pharma Group"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Iron deficiency (ID) is reported as one of the main co-morbidities in patients with chronic heart failure (CHF), which then influences quality of life and prognosis. The CARENFER study aimed to assess the prevalence of ID in a large panel of heart failure (HF) patients at different stages of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This prospective cross-sectional nationwide study was conducted in 48 medical units in France in 2019. Serum ferritin concentration and transferrin saturation (TSAT) index were determined in all eligible patients with a diagnosis of HF. ID diagnosis was based on the European Society of Cardiology (ESC) 2016 guidelines. Patients were classified as having either a decompensated HF or a CHF. Left ventricular ejection fraction (LVEF) was categorized as preserved (\u226550%), mildly reduced (40\u201349%), or reduced (&amp;lt;40%). ID diagnosis was determined in 1661 patients, of whom 1475 could be classified as having a decompensated HF or a CHF. Patients' median age was 78 years. Decompensated HF represented 60.1% of cases. The overall prevalence of ID was 49.6% (47.1\u201352.1). In CHF and decompensated HF patients, respectively, ID prevalence was 39.0% (35.1\u201343.1) and 58.1% (54.7\u201361.4), P &amp;lt; 0.001; TSAT &amp;lt; 20% was respectively reported in 34.7% and 70.0% of patients (P &amp;lt; 0.001). Patients with preserved LVEF were more likely to have an ID (57.5%) compared with patients with mildly reduced (47.4%) or reduced LVEF (44.3%) (P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Iron deficiency was highly prevalent in patients with decompensated HF or CHF with preserved LVEF. ID prevalence defined by TSAT was higher than by the ESC criteria in decompensated HF patients, questioning the importance of ID definition to assess its prevalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13850","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T02:14:11Z","timestamp":1644977651000},"page":"874-884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Iron Deficiency in Heart Failure Patients: The French CARENFER Prospective Study"],"prefix":"10.1093","volume":"9","author":[{"given":"Alain","family":"Cohen-Solal","sequence":"first","affiliation":[{"name":"Department of Cardiology and Vascular Disease, Paris University, UMR-S 942 MASCOT, Lariboisi\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris , 2 rue Ambroise Par\u00e9, Paris, 75010 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Philip","sequence":"additional","affiliation":[{"name":"Intensive Care Unit in Cardiology, Chalon Hospital , Chalon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Picard","sequence":"additional","affiliation":[{"name":"Cardiology Unit, H\u00f4pital du Haut L\u00e9v\u00eaque, University Hospital of Bordeaux, Bordeaux University , Pessac ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Delarche","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pau Hospital , Pau ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Taldir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Saint-Brieuc Hospital , Saint Brieuc ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heger","family":"Gzara","sequence":"additional","affiliation":[{"name":"Sud Francilien Hospital , Corbeil-Essonnes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa","family":"Korichi","sequence":"additional","affiliation":[{"name":"Vifor Pharma, Paris la D\u00e9fense , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Noel","family":"Trochu","sequence":"additional","affiliation":[{"name":"Institut du Thorax, University Hospital of Nantes, University of Nantes, CNRS, INSERM , Nantes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Cacoub","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, La Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Assistance Publique-H\u00f4pitaux de Paris , 83 Boulevard de l'H\u00f4pital, Paris, 75651 ,","place":["France"]},{"name":"Inflammation-Immunopathology-Biotherapy Department (DHU i2B), UPMC Univ Paris 06, UMR 7211, INSERM, UMRS 959, Sorbonne Universit\u00e9 , Paris, F-75005 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CARENFER Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"key":"2026012114170362900_ehf213850-bib-0001","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/ejhf.30","article-title":"Co-morbidities in patients with heart failure: an analysis of the European Heart Failure Pilot Survey","volume":"16","author":"van Deursen","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0002","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012114170362900_ehf213850-bib-0003","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ahj.2013.01.017","article-title":"Iron deficiency in chronic heart failure: an international pooled analysis","volume":"165","author":"Klip","year":"2013","journal-title":"Am Heart J"},{"key":"2026012114170362900_ehf213850-bib-0004","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1002\/ejhf.139","article-title":"High prevalence of iron deficiency in patients with acute decompensated heart failure","volume":"16","author":"Cohen-Solal","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0005","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.acvd.2019.02.002","article-title":"Dynamic iron status after acute heart failure","volume":"112","author":"Sportouch","year":"2019","journal-title":"Arch Cardiovasc Dis"},{"key":"2026012114170362900_ehf213850-bib-0006","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2019-001012","article-title":"Iron deficiency in heart failure with preserved ejection fraction: a systematic review and meta-analysis","volume":"6","author":"Beale","year":"2019","journal-title":"Open Heart"},{"key":"2026012114170362900_ehf213850-bib-0007","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/00015385.2017.1351239","article-title":"Impact of iron deficiency on exercise capacity and outcome in heart failure with reduced, mid-range and preserved ejection fraction","volume":"73","author":"Martens","year":"2018","journal-title":"Acta Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0008","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.recesp.2015.08.017","article-title":"Iron status in chronic heart failure: impact on symptoms, functional class and submaximal exercise capacity","volume":"69","author":"Enjuanes","year":"2016","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2026012114170362900_ehf213850-bib-0009","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.cardfail.2011.08.003","article-title":"Iron deficiency predicts impaired exercise capacity in patients with systolic chronic heart failure","volume":"17","author":"Jankowska","year":"2011","journal-title":"J Card Fail"},{"key":"2026012114170362900_ehf213850-bib-0010","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ijcard.2014.03.169","article-title":"Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study","volume":"174","author":"Enjuanes","year":"2014","journal-title":"Int J Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0011","doi-asserted-by":"crossref","DOI":"10.1186\/s12955-020-01566-y","article-title":"Impact of non-cardiovascular comorbidities on the quality of life of patients with chronic heart failure: a scoping review","volume":"18","author":"Com\u00edn-Colet","year":"2020","journal-title":"Health Qual Life Outcomes"},{"key":"2026012114170362900_ehf213850-bib-0012","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1161\/CIRCULATIONAHA.118.030099","article-title":"Anemia and iron deficiency in heart failure: current concepts and emerging therapies","volume":"138","author":"Anand","year":"2018","journal-title":"Circulation"},{"key":"2026012114170362900_ehf213850-bib-0013","volume-title":"Preview of the 2021 ESC\/HFA heart failure guidelines","author":"Rosano"},{"key":"2026012114170362900_ehf213850-bib-0014","volume-title":"Choix des examens du m\u00e9tabolisme du fer en cas de suspicion de crence en fer - Rapport d'\u00e9valuation","author":"French National Authority for Health (Haute Autorit\u00e9 de Sant\u00e9, France)","year":"2011"},{"key":"2026012114170362900_ehf213850-bib-0015","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-72057-9","article-title":"Iron deficiency markers in patients undergoing iron replacement therapy: a 9-year retrospective real-world evidence study using healthcare databases","volume":"10","author":"Cacoub","year":"2020","journal-title":"Sci Rep"},{"key":"2026012114170362900_ehf213850-bib-0016","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1161\/CIRCULATIONAHA.118.034271","article-title":"Sex differences in cardiovascular pathophysiology: why women are overrepresented in heart failure with preserved ejection fraction","volume":"138","author":"Beale","year":"2018","journal-title":"Circulation"},{"key":"2026012114170362900_ehf213850-bib-0017","first-page":"119","article-title":"Approximate is better than \u201cexact\u201d for interval estimation of binomial proportions","volume":"52","author":"Agresti","year":"1998","journal-title":"Am Stat"},{"key":"2026012114170362900_ehf213850-bib-0018","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jacc.2017.12.027","article-title":"The burden of iron deficiency in heart failure: therapeutic approach","volume":"71","author":"Rocha","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0019","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1002\/ejhf.513","article-title":"Iron deficiency and risk of early readmission following a hospitalization for acute heart failure","volume":"7","author":"N\u00fa\u00f1ez","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0020","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1002\/ejhf.837","article-title":"Iron status and inflammatory biomarkers in patients with acutely decompensated heart failure: early in-hospital phase and 30-day follow-up","volume":"19","author":"Van Aelst","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0021","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(20)32339-4","article-title":"Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial","volume":"396","author":"Ponikowski","year":"2020","journal-title":"Lancet"},{"key":"2026012114170362900_ehf213850-bib-0022","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00392-018-1344-x","article-title":"Iron deficiency in patients with heart failure with preserved ejection fraction and its association with reduced exercise capacity, muscle strength and quality of life","volume":"108","author":"Bekfani","year":"2019","journal-title":"Clin Res Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0023","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1002\/ejhf.823","article-title":"Effects of ferric carboxymaltose on hospitalisations and mortality rates in iron-deficient heart failure patients: an individual patient data meta-analysis","volume":"20","author":"Anker","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0024","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1002\/ejhf.473","article-title":"Effects of intravenous iron therapy in iron-deficient patients with systolic heart failure: a meta-analysis of randomized controlled trials","volume":"18","author":"Jankowska","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026012114170362900_ehf213850-bib-0025","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1001\/jamacardio.2019.1739","article-title":"Differences in clinical profile and outcomes of low iron storage vs defective iron utilization in patients with heart failure: results from the DEFINE-HF and BIOSTAT-CHF studies","volume":"4","author":"Beverborg","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0026","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/jamacardio.2016.1161","article-title":"Prevalence and outcomes of anemia and hematinic deficiencies in patients with chronic heart failure","volume":"1","author":"Cleland","year":"2016","journal-title":"JAMA Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0027","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ijcard.2020.03.020","article-title":"A reduced transferrin saturation is independently associated with excess morbidity and mortality in older adults with heart failure and incident anemia","volume":"309","author":"Ambrosy","year":"2020","journal-title":"Int J Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0028","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.ijcard.2017.04.110","article-title":"Clinical correlates and prognostic impact of impaired iron storage versus impaired iron transport in an international cohort of 1821 patients with chronic heart failure","volume":"243","author":"Moliner","year":"2017","journal-title":"Int J Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0029","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1080\/10408363.2019.1653820","article-title":"Using transferrin saturation as a diagnostic criterion for iron deficiency: a systematic review","volume":"56","author":"Cacoub","year":"2019","journal-title":"Crit Rev Clin Lab Sci"},{"key":"2026012114170362900_ehf213850-bib-0030","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.3945\/ajcn.114.103366","article-title":"Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review","volume":"102","author":"Peyrin-Biroulet","year":"2015","journal-title":"Am J Clin Nutr"},{"key":"2026012114170362900_ehf213850-bib-0031","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1016\/j.amjcard.2016.08.081","article-title":"Usefulness of iron deficiency correction in management of patients with heart failure [from the Registry Analysis of Iron Deficiency-Heart Failure (RAID-HF) registry]","volume":"118","author":"Wienbergen","year":"2016","journal-title":"Am J Cardiol"},{"key":"2026012114170362900_ehf213850-bib-0032","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1002\/ejhf.1305","article-title":"Screening, diagnosis and treatment of iron deficiency in chronic heart failure: putting the 2016 European Society of Cardiology heart failure guidelines into clinical practice","volume":"20","author":"McDonagh","year":"2018","journal-title":"Eur J Heart Fail"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13850","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13850","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/2\/874\/65375768\/eschf_9_2_874.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/2\/874\/65375768\/eschf_9_2_874.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:20:30Z","timestamp":1769023230000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/2\/874\/8326224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,15]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,15]]},"published-print":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13850","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,4]]},"published":{"date-parts":[[2022,2,15]]},"assertion":[{"value":"2021-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}