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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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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 |
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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 |
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