Association between iron status biomarkers and prognosis after acute coronary syndrome
Key Takeaways
This prospective, multi-center, observational study found that high frequency measurements of iron and transferrin saturation (TSAT) predicted adverse outcomes in patients hospitalized for acute coronary syndrome (ACS) during 1 year follow-up.
This study highlights the potential benefit of routine screening of iron status biomarkers in this population. Future studies focused on evaluating the safety and efficacy of iron supplementation on long-term outcomes in patients with post-ACS are needed.
Iron deficiency is a frequent co-morbidity in heart failure patients and has been linked to an increased risk of death and lower quality of life.
Why This Study Matters
However, more research is needed to evaluate the predictive value and clinical implications of iron status on outcomes in coronary heart disease (CHD) patients. To address this need, this study explored the temporal pattern of repeat measurements of iron, ferritin, transferrin, and TSAT and their association with post-ACS outcomes.
Study Design
This study enrolled 844 patients, aged >40 years, who were hospitalized for ACS, in the Netherlands between 2008 and 2015. Patients underwent repeat venipuncture during the year after hospitalization, including upon hospital admission, discharge, as well as every two weeks during the first 6 months and once a month thereafter.
The primary outcome of the study was a composite endpoint of cardiovascular death and repeat nonfatal ACS, including unstable angina pectoris requiring revascularization.
Investigators analyzed the correlation between iron status and the primary endpoint using multivariable joint models.
Results and Conclusions
The average participant age was 63 years and males comprised 78% of subjects.
Repeated measurements of iron and TSAT were significantly associated with the primary endpoint of cardiovascular death and repeat nonfatal ACS, while ferritin and transferrin were not.
A 1 SD decrease in log-iron and log-TSAT was associated with a 2.2-fold and 1.78-fold increased risk of the primary endpoint, respectively.
Upon removal of the initial 30 days post hospitalization from the analysis, iron and TSAT were no longer found to be significantly associated with the primary endpoint.
Related Research
Consider these findings from similar research studies:
Acute coronary syndrome patients with iron deficiency have worse long-term outcomes (Source).
TSAT and serum iron levels predict heart failure patients most at risk of cardiovascular death (Source).
Original Source
Gürgöze MT, Kardys I, Akkerhuis KM, et al. Relation of iron status to prognosis after acute coronary syndrome. The American Journal of Cardiology. Published online January 2022:S0002914921012418.