title: Serum iron concentration, but not hemoglobin, correlates with TIMI risk score and 6-month left ventricular performance after primary angioplasty for acute myocardial infarction.
abstract: OBJECTIVE
  Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognostic value of serum iron concentration on LV ejection fraction (EF) at 6 months and its relationship to thrombolysis in myocardial infarction (TIMI) risk score in post MI patients.
  
  
  METHODS
  We recruited 55 patients who were scheduled to undergo primary coronary balloon angioplasty after AMI and 54 age- and sex-matched volunteers. Serum iron concentration and interleukin-6 levels were measured before primary angioplasty. LVEF was measured by echocardiography at baseline and after 6 months. TIMI risk score was calculated for risk stratification.
  
  
  RESULTS
  Serum iron concentration was significantly lower in those in whom LVEF had not improved ≥ 10% from baseline (52.7 ± 24.1 versus 80.8 ± 50.8 µg/dl, P = 0.016) regardless of hemoglobin level, and was significantly lower in the AMI group than in the control group (62.5 ± 37.7 versus 103.0 ± 38.1 µg/dl, P<0.001). Trend analysis revealed that serum iron concentration decreased as TIMI risk score increased (P = 0.002). In addition, lower serum iron concentrations were associated with higher levels of inflammatory markers. Multiple linear regression showed that baseline serum iron concentration can predict LV systolic function 6 months after primary angioplasty for AMI even after adjusting for traditional prognostic factors.
  
  
  CONCLUSIONS
  Hypoferremia is not only a marker of inflammation but also a potential prognostic factor for LV systolic function after revascularization therapy for AMI, and may be a novel biomarker for therapeutic intervention.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Huang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Chia-Chu
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chen-Ling
authors.initials: CL
authors.lastname: Kuo
authors.affiliation: Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Ching-Shan
authors.initials: CS
authors.lastname: Huang
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Tzai-Wen
authors.initials: TW
authors.lastname: Chiu
authors.affiliation: Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan; Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chin-San
authors.initials: CS
authors.lastname: Liu
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D007501:Iron
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