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Cross-Sectional Study Demonstrating Specificity of Iron Kinetics in Atrial Fibrillation
Takahiro Kamihara1, Shinji Kaneko2, Takuya Omura3
1Department of Cardiology, National Center for Geriatrics and Gerontology Aichi Japan.
Insights
Anemia and iron deficiency are common in cardiology outpatients. Iron metabolism differs significantly between patients with sinus rhythm and atrial fibrillation, suggesting chronic inflammation in the latter.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Iron metabolism is crucial for diagnosing anemia and inflammation in cardiovascular disease (CVD).
- Limited data exists on anemia, iron deficiency, and overload prevalence in cardiology outpatients.
- The impact of specific CVDs on iron kinetics is not fully understood.
Purpose of the Study:
- To assess the prevalence of anemia and iron kinetics abnormalities in cardiology outpatients.
- To investigate the relationship between iron metabolism and heart rhythm (sinus rhythm vs. atrial fibrillation).
- To explore the influence of atrial fibrillation on iron dynamics.
Main Methods:
- Retrospective analysis of 260 cardiology outpatients.
- Comprehensive blood sampling for anemia and iron kinetics evaluation.
- Statistical analysis including multivariate regression.
Main Results:
- Anemia prevalence was 36.1%; iron deficiency was 13.8% in outpatients.
- Stored iron correlated with free iron in sinus rhythm but not in atrial fibrillation (AF).
- Iron dynamics influenced hemoglobin in sinus rhythm but not in AF patients.
Conclusions:
- Iron dynamics show a distinct profile in AF patients, differing from sinus rhythm patients.
- The abolished correlation between transferrin saturation and stored iron in AF supports chronic inflammation.
- Findings highlight unique iron metabolism patterns in AF within the CVD spectrum.
Background:
In the context of cardiovascular disease (CVD), iron metabolism assessment plays a pivotal role in the diagnosis of anemia and chronic inflammation. However, data regarding the prevalence of anemia, iron deficiency, and iron overload among outpatients in real-world clinical settings remain limited. Moreover, the influence of specific diseases on iron kinetics within the CVD spectrum has not been fully elucidated.
Methods And Results:
We conducted a retrospective analysis of 260 patients attending a cardiology outpatient clinic who had undergone blood sampling for comprehensive evaluation of anemia and iron kinetics. The prevalence of anemia among these outpatients was 36.1%, but iron deficiency was observed in only 13.8% of patients (absolute iron deficiency: 1.5%). Notably, stored iron positively correlated with free iron in patients with sinus rhythm, but not in patients with atrial fibrillation (AF). Intriguingly, this relationship followed a similar pattern in the paroxysmal and longstanding AF subgroups. Moreover, multivariate regression analysis showed that iron dynamics significantly explained hemoglobin levels in patients with sinus rhythm but not in those with AF.
Conclusions:
Although chronic inflammation may be a contributing factor, iron dynamics exhibited a distinct profile in patients with AF. The correlation between transferrin saturation and stored iron, evident in sinus rhythm patients, was abolished in AF, which supports the notion of chronic inflammation in patients with AF.
