Abstract Background Acute coronary syndromes (ACS) are associated with high mortality and morbidity. Iron has been implicated in cardiovascular (CV) diseases, particularly heart failure (HF). However, the impact of iron deficiency on ACS remains unclear. Purpose The aim of the study was to assess the influence of iron deficiency in patients hospitalized for ACS on HF at 2 months and hospitalization and mortality at 12 months. Methods A retrospective single-center study of patients admitted and followed due to ACS between January 2021 and July 2024 and who had in-hospital ferritin and transferrin saturation levels was conducted. Patients who had in-hospital dead were excluded. CV risk factors, comorbidities and medication at admission, ACS characterization and laboratory and echocardiographic data were collected. HF, hospitalization and mortality were registered. Chi-square and Mann-Whitney tests were used to compare patients with versus without iron deficiency at admission (defined as ferritin below 100ug/L or ferritin between 100 and 300ug/L and transferrin saturation below 20%). Results This study included 117 patients, 67.5% (n = 79) males, with a median age of 72 19 years old. There was a high prevalence of CV risk factors. Almost 25% (n = 29) had previous coronary artery disease and only 7 patients (6%) had HF. Seven patients were on oral iron supplementation. More than half of the patients were admitted with ST-segment elevation myocardial infarction (58.1%, n = 68), on Killip-Kimball class I (68.4%, n = 80), and treated percutaneously (70.9%, n = 83), with preserved ejection fraction in 44.8% (n = 52) of the cases and a median NTproBNP of 1818 4653 pg/mL. At admission, 46.2% of patients had iron deficiency (20.6% absolute and 25.6% relative). Iron deficiency was more frequent in women (66.8% versus 38.0% in men, p = 0.011). There were no significant differences regarding CV risk factors or comorbidities, although chronic kidney disease was more prevalent in patients without iron deficiency (30.2% versus 14.8% of those with iron deficiency, p = 0.050). Patients with iron deficiency received more intravenous iron supplementation (p 0.001). At 2 months, 53.9% (n = 62) of the patients had HF. At 12 months, 19 (17.2%) patients were hospitalized, and 9 (7.8%) deaths were registered. No statistically significant associations were found between iron deficiency and HF at 2 months nor with hospitalization and mortality at 12 months. Conclusion This study revealed that iron deficiency is a very prevalent nutritional disorder in ACS, higher in women. Its presence was not correlated with clinical outcomes at 2 and 12 months after ACS. These findings suggest that, in the context of ACS, iron deficiency may not independently impact short- or mid-term clinical outcomes, though larger prospective studies are warranted to further clarify the need for screening for this condition and its prognostic significance and potential therapeutic implications.
Almeida et al. (Fri,) studied this question.