Cargando…

Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome

Acute myocardial infarction remains a leading cause of morbidity and mortality. While iron deficient heart failure patients are at increased risk of future cardiovascular events and see improvement with intravenous supplementation, the clinical relevance of iron deficiency in acute coronary syndrome...

Descripción completa

Detalles Bibliográficos
Autores principales: Zeller, Tanja, Waldeyer, Christoph, Ojeda, Francisco, Schnabel, Renate B., Schäfer, Sarina, Altay, Alev, Lackner, Karl J., Anker, Stefan D., Westermann, Dirk, Blankenberg, Stefan, Karakas, Mahir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163749/
https://www.ncbi.nlm.nih.gov/pubmed/30037035
http://dx.doi.org/10.3390/biom8030060
_version_ 1783359436059836416
author Zeller, Tanja
Waldeyer, Christoph
Ojeda, Francisco
Schnabel, Renate B.
Schäfer, Sarina
Altay, Alev
Lackner, Karl J.
Anker, Stefan D.
Westermann, Dirk
Blankenberg, Stefan
Karakas, Mahir
author_facet Zeller, Tanja
Waldeyer, Christoph
Ojeda, Francisco
Schnabel, Renate B.
Schäfer, Sarina
Altay, Alev
Lackner, Karl J.
Anker, Stefan D.
Westermann, Dirk
Blankenberg, Stefan
Karakas, Mahir
author_sort Zeller, Tanja
collection PubMed
description Acute myocardial infarction remains a leading cause of morbidity and mortality. While iron deficient heart failure patients are at increased risk of future cardiovascular events and see improvement with intravenous supplementation, the clinical relevance of iron deficiency in acute coronary syndrome remains unclear. We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). Levels of ferritin, iron, and transferrin were measured at baseline in 836 patients with ACS. A total of 29.1% was categorized as iron deficient. The prevalence of iron deficiency was clearly higher in women (42.8%), and in patients with anemia (42.5%). During a median follow-up of 4.0 years, 111 subjects (13.3%) experienced non-fatal myocardial infarction (MI) and cardiovascular mortality as combined endpoint. Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI) This association remained significant (HR 1.73 (95% CI 1.07–2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). Survival analyses for cardiovascular mortality and MI provided further evidence for the prognostic relevance of iron deficiency (HR 1.50 (95% CI 1.02–2.20)). Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome.
format Online
Article
Text
id pubmed-6163749
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-61637492018-10-10 Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome Zeller, Tanja Waldeyer, Christoph Ojeda, Francisco Schnabel, Renate B. Schäfer, Sarina Altay, Alev Lackner, Karl J. Anker, Stefan D. Westermann, Dirk Blankenberg, Stefan Karakas, Mahir Biomolecules Article Acute myocardial infarction remains a leading cause of morbidity and mortality. While iron deficient heart failure patients are at increased risk of future cardiovascular events and see improvement with intravenous supplementation, the clinical relevance of iron deficiency in acute coronary syndrome remains unclear. We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). Levels of ferritin, iron, and transferrin were measured at baseline in 836 patients with ACS. A total of 29.1% was categorized as iron deficient. The prevalence of iron deficiency was clearly higher in women (42.8%), and in patients with anemia (42.5%). During a median follow-up of 4.0 years, 111 subjects (13.3%) experienced non-fatal myocardial infarction (MI) and cardiovascular mortality as combined endpoint. Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI) This association remained significant (HR 1.73 (95% CI 1.07–2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). Survival analyses for cardiovascular mortality and MI provided further evidence for the prognostic relevance of iron deficiency (HR 1.50 (95% CI 1.02–2.20)). Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome. MDPI 2018-07-20 /pmc/articles/PMC6163749/ /pubmed/30037035 http://dx.doi.org/10.3390/biom8030060 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zeller, Tanja
Waldeyer, Christoph
Ojeda, Francisco
Schnabel, Renate B.
Schäfer, Sarina
Altay, Alev
Lackner, Karl J.
Anker, Stefan D.
Westermann, Dirk
Blankenberg, Stefan
Karakas, Mahir
Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title_full Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title_fullStr Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title_full_unstemmed Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title_short Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome
title_sort adverse outcome prediction of iron deficiency in patients with acute coronary syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163749/
https://www.ncbi.nlm.nih.gov/pubmed/30037035
http://dx.doi.org/10.3390/biom8030060
work_keys_str_mv AT zellertanja adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT waldeyerchristoph adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT ojedafrancisco adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT schnabelrenateb adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT schafersarina adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT altayalev adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT lacknerkarlj adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT ankerstefand adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT westermanndirk adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT blankenbergstefan adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome
AT karakasmahir adverseoutcomepredictionofirondeficiencyinpatientswithacutecoronarysyndrome