Abstract 18474: Iron Deficiency Independently and Strongly Predicts Risk of Cardiovascular Death and Myocardial Infarction in Patients With Acute Coronary Syndrome
Objective: The clinical relevance of iron deficiency (ID) in acute coronary syndrome (ACS) remains unclear. We aimed to evaluate the prognostic value of ID in ACS.
Methods: In the prospective AtheroGene study (n=836), levels of ferritin, iron and transferrin were measured. ID was defined as ferritin below 100 μg/L, or as ferritin between 100-299 μg/L, if the transferrin saturation was below 20%. The main outcomes were nonfatal myocardial infarction (MI) and cardiovascular (CV) death.
Results: 29.3 % of the subjects were categorized as iron deficient. ID prevalence was higher in women (41.0 %), and in patients with anaemia (45.7 %). During a median follow-up of 4.0 years, 13.3 % suffered an endpoint. ID strongly predicted MI and CV death in multivariate Cox regression adjusted for sex, age, BMI, smoking, hypertension, diabetes, and dyslipidemia (HR 1.52 [95 % CI 1.03 - 2.26; p=0.037]) and remained significant (HR 1.73 [95 % CI 1.07 - 2.81; p=0.026]) after additional adjustment for NT-proBNP, troponin and hemoglobin. Survival analyses for CV death/ MI provided further prognostic relevance of ID (HR 1.50 [95 % CI 1.02-2.20]).
Conclusion: ID has a high prevalence and is strongly associated with adverse outcome in ACS patients. These data might pave the way for a first controlled clinical trial.
Author Disclosures: M. Karakas: None. C. Waldeyer: None. F. Ojeda: None. R. Schnabel: None. K. Lackner: None. S. Anker: None. D. Westermann: None. S. Blankenberg: None. T. Zeller: None.
- © 2016 by American Heart Association, Inc.