ABC | Volume 111, Nº2, August 2018

Original Article Duarte et al Iron impact in acute coronary syndrome Arq Bras Cardiol. 2018; 111(2):144-150 60 40 40 50 30 20 20 10 0 0 0 0 250 50 500 100 150 200 250 750 1000 1250 Frequency Frequency Mean: 204.5 Standard deviation: 184.7 Mean: 59.02 Standard deviation: 34.2 Ferritin Iron Figure 1 – Distribution of serum levels of iron and ferritin in the population. Table 3 – Short-term and long-term events, according to iron levels Event 1 st iron tertile (≤ 40 mcg/dL) 2 nd iron tertile (> 40 or ≤ 67 mcg/dL) 3 rd iron tertile (> 67 mcg/dL) p value In-hospital death 3 0 0 0.04 Death at 1 year 12 4 3 0.02 In-hospital HF 46 19 14 < 0.001 HF at 1 year 17 9 7 0.08 Reinfarction at 1 year 3 3 2 0.9 CVA at 1 year 0 1 1 0.8 HF: heart failure; CVA: cerebrovascular accident. Table 4 – Short-term and long-term events, according to ferritin levels Event 1 st ferritin tertile (≤ 110 ng/mL) 2 nd ferritin tertile (> 110 or ≤ 219 ng/mL) 3 rd ferritin tertile (> 219 ng/mL) p value In-hospital death 1 1 1 0.8 Death at 1 year 9 2 8 0.04 In-hospital HF 38 16 25 0.001 HF at 1 year 13 9 11 0.1 Reinfarction at 1 year 4 3 1 0.1 CVA at 1 year 1 1 0 0.5 HF: heart failure; CVA: cerebrovascular accident. Is ferritin a cytoprotective or atherogenic agent or, on the other hand, is its deficiency a predictor of major cardiovascular events in patients with ACS? The literature results are not in agreement regarding the role of ferritin in atherosclerosis. 3 Patients with ACS and major cardiovascular events (MACE) showed low levels of ferritin versus patients with ACS without adverse events. 5 In our population, regarding ferritin levels, the 1 st and 3 rd tertiles were associated with the occurrence of more adverse events, with statistical significance in terms of in-hospital HF and 1-year death. A serum ferritin level of 316 ng/mL was considered an independent risk predictor for 1-year death (adjusted OR:14; 95%CI: 2.6-75.9, p = 0.0023), which 147