OBJECTIVETo evaluate the predictive value of serum iron level for in-hospital acute heart failure (AHF) after acute ST-elevated myocardial infarction (STEMI).

METHODSThis retrospective study involved 287 patients with STEMI stratified by quartiles of admission serum iron concentration. The incidence of AHF was assessed by serum iron quartiles. We evaluated the association of serum iron levels with B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), and high-sensitivity C-reactive protein (hs-CRP) levels on admission, and analyzed the correlation of serum iron levels with in-hospital AHF, death, and duration of hospital stay.

RESULTSThe average serum iron level on admission of the 287 STEMI patients was 10.20 µmol/L (6.90-14.40 µmol/L), and the quartiles (Q) of serum iron levels were ≤6.90 µmol/L (Q(1)), 6.91-10.19 µmol/L (Q(2)), 10.20-14.39 µmol/L (Q(3)), and ≥14.40 µmol/L (Q(4)). The incidences of in-hospital AHF from Q(1) to Q(4) were 79.5%, 64.3%, 50.0% and 45.9%, respectively (P<0.001). Univariate logistic regression analysis showed that low admission serum iron level (Q(1)) was an independent predictor for in-hospital AHF (OR=3.358, 95%CI 1.791- 6.294, P<0.001), and multivariate logistic regression analysis showed a similar result (OR=2.316, 95%CI 1.205-4.453, P=0.012).

CONCLUSIONSA lower admission serum iron level is an independent predictor of AHF in STEMI patients during hospitalization.