Prognostic Impact of Iron Metabolism Changes in Patients with Acute Coronary Syndrome
Tatiana Duarte1, Sara Gonçalves1, Catarina Sá1
1Centro Hospitalar de Setúbal EPE, Setúbal - Portugal.
Insights
Altered iron metabolism and elevated ferritin levels predict worse outcomes in acute coronary syndrome (ACS) patients. Higher ferritin is an independent risk factor for long-term mortality after ACS.
Area of Science:
- Cardiology
- Internal Medicine
- Biochemistry
Background:
- Iron metabolism disorders are linked to cardiovascular disease risk.
- The prognostic significance of iron levels in acute coronary syndrome (ACS) requires further clarification.
Purpose of the Study:
- To assess the prognostic value of serum iron and ferritin levels in ACS patients.
- Evaluate short-term and long-term outcomes related to iron metabolism.
Main Methods:
- A 2-year prospective study of 280 ACS patients admitted to a coronary care unit.
- Patients were stratified into tertiles based on serum iron and ferritin levels.
- Primary endpoints included in-hospital and 1-year mortality or heart failure (HF).
Main Results:
- Low serum iron (≤ 40 mcg/dL) correlated with increased in-hospital and 1-year adverse events.
- Both low and high ferritin levels (≤ 110 ng/mL and >219 ng/mL) were associated with higher HF incidence and 1-year mortality.
- Ferritin >316 ng/mL independently predicted 1-year mortality (adjusted OR: 14).
Conclusions:
- Iron metabolism alterations are associated with adverse outcomes in ACS patients.
- Elevated ferritin levels serve as an independent predictor of long-term mortality in this population.
Background:
Iron metabolism disorders have been associated with an increased risk of cardiovascular events. However, the prognostic impact on patients (pts) with acute coronary syndrome (ACS) has yet to be clarified.
Objective:
To determine the prognostic value of serum iron and ferritin levels in pts with ACS in the short and long-term.
Methods:
Consecutive pts admitted to a coronary care unit with a diagnosis of ACS, for a period of 2 years, were evaluated. The population was divided into tertiles of serum iron and ferritin distribution. The primary adverse events were the occurrence of in-hospital death or heart failure (HF) and death or HF at 1 year of follow-up.
Results:
We studied 280 pts (73% males; mean age 68 ± 13 years). The mean levels of serum iron and ferritin were 59 ± 34 mcg/dL and 205 ± 185 ng/mL, respectively. Patients included in the 1st tertile of serum iron (≤ 40 mcg/dL) had a higher rate of adverse events, in-hospital and after 1 year. Lower and higher levels of ferritin (1st and 3rd tertiles, ≤ 110; >219 ng/ml, respectively) were associated with a higher incidence of HF during hospitalization and death at 1 year. A ferritin value >316 ng /mL was an independent risk factor for death at 1 year (adjusted OR: 14; 95%CI: 2.6 to 75.9).
Conclusion:
In this population, iron metabolism alterations were associated with a higher rate of adverse events and higher ferritin levels constituted an independent mortality predictor in the long-term.
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