Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction

Abstract

ObjectiveAnemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognostic value of serum iron concentration on LV ejection fraction (EF) at 6 months and its relationship to thrombolysis in myocardial infarction (TIMI) risk score in post MI patients.MethodsWe recruited 55 patients who were scheduled to undergo primary coronary balloon angioplasty after AMI and 54 age- and sex-matched volunteers. Serum iron concentration and interleukin-6 levels were measured before primary angioplasty. LVEF was measured by echocardiography at baseline and after 6 months. TIMI risk score was calculated for risk stratification.ResultsSerum iron concentration was significantly lower in those in whom LVEF had not improved ≥10% from baseline (52.7±24.1 versus 80.8±50.8 µg/dl, P = 0.016) regardless of hemoglobin level, and was significantly lower in the AMI group than in the control group (62.5±37.7 versus 103.0±38.1 µg/dl, P<0.001). Trend analysis revealed that serum iron concentration decreased as TIMI risk score increased (P = 0.002). In addition, lower serum iron concentrations were associated with higher levels of inflammatory markers. Multiple linear regression showed that baseline serum iron concentration can predict LV systolic function 6 months after primary angioplasty for AMI even after adjusting for traditional prognostic factors.ConclusionHypoferremia is not only a marker of inflammation but also a potential prognostic factor for LV systolic function after revascularization therapy for AMI, and may be a novel biomarker for therapeutic intervention.

Lower mean corpuscular hemoglobin concentration is associated with poorer outcomes in intensive care unit admitted patients with acute myocardial infarction

“…Our hypothesis was supported by a recently published work, which shown that MCHC was negatively correlated with RDW in AMI patients (36). Actually, higher serum iron was proved to be associated with better outcomes in AMI patients (37).…”

Is Correction of Iron Deficiency a New Addition to the Treatment of the Heart Failure?

“…There are many conditions in which the prevalence of ID is increased but no adequate studies of iron administration have been performed to assess their effect on ID, anemia and patient performance. These include: heart and kidney transplantation [ 96 ], obesity [ 97 , 98 , 99 ], metabolic syndrome [ 100 ], diabetes [ 101 ], elderly [ 102 ], stroke [ 103 ], peripheral vascular disease [ 104 ], coronary artery disease [ 105 , 106 , 107 , 108 , 109 ], thromboembolism [ 110 ], chronic obstructive pulmonary disease (COPD) [ 111 , 112 ] and asthma [ 113 ].…”

Anemia in Intensive Cardiac Care Unit patients – An underestimated problem

“…It has been proposed that hypoferremia might be a 199 potential prognostic risk factor of durable LV systolic dysfunction 200 after successful primary revascularization in AMI patients and may 201 be a novel biomarker for therapeutic intervention[21].202 2.1.3. Myocardial infarction type 2 vs. type 1 203 In 2007 a joint Task Force of ACC/AHA/ESC/WHF published a 204 new definition of AMI.…”