Prevalence and prognosis of iron deficiency in acute myocardial infarction

Abstract

Coronary artery disease (CAD) and iron deficiency (ID) are two common pathologies, but the potential role of iron in the pathophysiology of CAD through inflammation and atherosclerosis is still being debated. To evaluate the prevalence and prognosis of ID in CAD patient after acute myocardial infarction (AMI). Patients hospitalised for AMI in two cardiology centres were screened for ID in the first 48 hours after admittance. ID was defined as transferring saturation less than 20% (T-SAT < 20%). All-cause mortality 6 months after MI was the primary end-point. GRACE and CRUSADE scores, left ventricular ejection fraction (LVEF), severity of CAD (defined by TIMI and SYNTAX angiographic scores), length of hospital stay (LOS), increased C-reactive protein (CRP), troponin IC, and natriuretic peptides were the secondary endpoints. Half (49%) of the 145 patients included were diagnosed with ID (average age 66.5 ± 13.4 years, 30% were women and 30% over 75 years- old). Six months overall survival of ID patients was impaired: 83.1% vs. 100%, in non-ID patients ( P < 0.001). On admittance, ID patients also had increased GRACE and CRUSADE scores ( P < 0.0001 and < 0.01, respectively); lower LVEF ( P < 0.01); more frequent coronary occlusions ( P < 0.004); higher SYNTAX score ( P < 0.0001); more common multi-vessel involvement ( P < 0.007); LOS often over one week ( P < 0.001); more severe inflammation ( P < 0.0001); higher natriuretic peptides levels ( P < 0.03) ( Fig. 1 ). ID is highly prevalent among patients hospitalised for MI and associated with higher mortality at 6 months and greater severity of CAD. Whether its presence impacts long-term survival needs further studies.