Iron deficiency and long-term mortality in elderly patients with acute coronary syndrome

Abstract

Aim: We evaluated the relationship between iron deficiency (ID) and long-term mortality risk in elderly patients with acute coronary syndrome (ACS).

Methods: In this prospective observational study, we included 252 patients older than 65 years with ACS. Transferrin saturation (TSAT) and ferritin were collected before discharge.

Results: Mean age, hemoglobin and GRACE score were 78 ± 7 years, 12.4 ± 1.8 g/dl and 138.8 ± 25.3, respectively, 112(44.4%) patients were women, and 151(59.9%) presented ID. During the follow-up, 121 (48%) patients died. Mortality rates among TSAT quartiles were: 2.38, 1.60, 0.90 and 0.95 × 10 person-years for Q1TSAT to Q4TSAT, respectively (p < 0.001) and did not differ across ferritin quartiles (p = 0.601), whereas ID definition was borderline associated (p = 0.060). Adjusted TSAT levels remained inverse, nonlinearly associated with long-term mortality risk (p < 0.001), with an exponential increased-risk from values about 20% and below.

Conclusion: Lower TSAT levels were independently associated with increased mortality risk in these patients.

Keywords: acute coronary syndrome; elderly patients; ferritin; iron deficiency; transferrin saturation.