{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:52:00Z","timestamp":1781769120573,"version":"3.54.5"},"posted":{"date-parts":[[2026,6,15]]},"group-title":"Cardiovascular Medicine","reference-count":23,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Given around 50% of people with heart failure have a degree of iron deficiency, guidelines recommend screening. It is uncertain to what extent this is done in primary care and whether testing is equitable.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To report the proportion of people with incident heart failure who undergo a ferritin test within 12 months.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design and setting<\/jats:title>\n                  <jats:p>Retrospective primary care cohort study using Clinical Practice Research Datalink Aurum data, between 2016 and 2021.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We report the proportion of adults with an incident diagnosis of heart failure who received a ferritin test within 12 months. Multivariable logistic regression was used to examine the odds of testing based on key demographic covariates and co-morbidities.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 105,749 individuals with an incident diagnosis of heart failure (mean age 71.6 years, SD 14.3), only 35,688 (33.7%) received a ferritin test within the subsequent year. Increasing age (odds ratio 1.25 per 10-year increase, 95% CI: 1.24\u20131.27), female sex (male sex OR 0.86, 0.84\u20130.89) and Asian ethnicity (OR 1.70, 1.59\u20131.80) were all associated with increased odds of testing as were diagnoses of coeliac disease (OR 1.86, 1.58-2.21), type 1 diabetes (OR 1.82, 1.51-2.19) and cirrhosis (OR 1.64, 1.43-1.87). There was geographic variation in testing, even in adjusted analyses.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In a large primary care dataset, two thirds of people with incident heart failure did not receive a ferritin test for iron deficiency within a year of diagnosis demonstrating a gap in current practice and an opportunity for improvements in service delivery.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.06.14.26355616","type":"posted-content","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:20:16Z","timestamp":1781572816000},"source":"Crossref","is-referenced-by-count":0,"title":["Iron deficiency testing among people with incident heart failure in primary care"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7162-7695","authenticated-orcid":false,"given":"Vijay","family":"Maharajan","sequence":"first","affiliation":[{"name":"Cardio-Oncology Service, Royal Brompton Hospital Centre of Excellence, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, UK"},{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0352-3785","authenticated-orcid":false,"given":"Nicholas R","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Bankhead","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Erone","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Haynes","sequence":"additional","affiliation":[{"name":"University of Oxford, Nuffield Department of Women\u2019s and Reproductive Health, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin M","family":"Katumba","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"},{"name":"Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christien Ka Hou","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oxford University Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Maynard","sequence":"additional","affiliation":[{"name":"University of Oxford, Radcliffe Department of Medicine, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi BA","family":"Roy","sequence":"additional","affiliation":[{"name":"University of Oxford, Radcliffe Department of Medicine, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J","family":"Stanworth","sequence":"additional","affiliation":[{"name":"University of Oxford, Radcliffe Department of Medicine, Oxford, UK"},{"name":"Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK"},{"name":"Department of Transfusion Medicine, NHS Blood and Transplant, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0946-742X","authenticated-orcid":false,"given":"Margaret","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7196-1509","authenticated-orcid":false,"given":"Cynthia Wright","family":"Drakesmith","sequence":"additional","affiliation":[{"name":"University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, 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