Prognostic impact of iron deficiency in acute coronary syndromes

Iron deficiency (IDef) is a prevalent condition in patients with heart disease and in those with heart failure (HF). Evidence has shown that this deficit is associated with worse prognosis. Data in literature are scarce on the prognostic impact of IDef in acute coronary syndromes (ACS), which is the main objective of this study. Observational, retrospective study which included 817 patients admitted for ACS. Two groups were defined according to the presence (n=298) or absence of IDef (n=519) on admission. The clinical event under study was the occurrence of death or severe HF in the long term. Independent predictors of prognosis were determined with logistic regression analysis. Thirty-six percent of patients had IDef. There was higher mortality (p=0.004), higher incidence of HF (p=0.011) during follow-up and a higher rate of hospital readmissions (p=0.048) in this group. IDef was an independent predictor of death or severe HF in follow-up, along with anemia, left ventricular dysfunction, renal dysfunction and the absence of revascularization. IDef also enabled us to further stratify the prognosis of patients without anemia based on the occurrence of death or severe HF and those with lower Killip classes (≤2) based on the occurrence of death. IDef was an independent predictor of death or severe HF in patients admitted with ACS and enabled additional stratification for those without anemia on admission and in those with Killip classes ≤2. O défice de ferro (DeF) é uma condição prevalente em doentes com patologia cardíaca e naqueles com Insuficiência Cardíaca (IC) demonstrou-se que esse défice se associa a pior prognóstico. Existem poucos dados na literatura relativamente ao impacto prognóstico do DeF nas Síndromes Coronárias Agudas (SCA), sendo este o principal objetivo deste estudo. Estudo observacional retrospetivo que incluiu 817 doentes admitidos por SCA. Definiram-se dois grupos de acordo com a presença (n=298) ou ausência de DeF (n=519) à admissão. O evento clínico estudado foi a ocorrência de morte ou IC grave a longo prazo. Calcularam-se os preditores independentes de prognóstico com base na análise de regressão logística. Verificou-se que 36% dos doentes tinham DeF. Estes doentes apresentaram maior taxa de mortalidade (p=0,004) e de IC (p=0,011) durante o follow-up bem como maior taxa de readmissões hospitalares (p=0,048). O DeF foi preditor independente de morte ou IC grave no follow-up, a par da anemia, da disfunção do ventrículo esquerdo, da dis