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 1.0 0.8 0.6 0.4 0.2 0.0 1.0 0.8 0.6 0.4 0.2 0 5 10 15 20 0 2 4 6 8 10 12 Accumulated Survival Accumulated Survival Death_months HF_months p = 0.49 p = 0.52 Iron tertile Iron tertile 1 2 3 1 2 3 Figure 2 – Survival curves according to iron tertiles. Table 5 – Establishment of independent variables associated with cardiovascular events in the short and long-term. Variable Odds ratio 95%CI p value Death at 1 year Iron ≤ 36 mcg/dL 2.6 0.7-9 0.13 Ferritin > 316 ng/mL 14 2.5-75 0.0027 Hemoglobin ≤ 11.7 g/dL 17 3-102 0.0016 Age > 70 year 21 2-237 0.01 In-hospital death Iron ≤ 14 mcg/dL 3.9 1-9 0.99 Ferritin > 104 ng/ml 1.17 2-70 0.99 Heart failure at 1 year Iron ≤ 40 mcg/dL 0.9 0.2-3.9 0.9 Ferritin ≤ 157 ng/mL 0.36 0.06-2.1 0.2 In-hospital heart failure Iron ≤ 30 mcg/dL 1.8 0.6-5.3 0.3 Ferritin ≤ 116 ng/mL 0.5 0.15-1.8 0.3 Values determined from the Receiver Operating Characteristic curves. 95% CI: 95% confidence interval. differs from the conclusions of some studies, as previously mentioned. The serum ferritin level was not an independent risk predictor for heart failure. Limitations The present study is subject to the limitations associated with all retrospective, non-randomized analyses carried out in a single center. Conclusion In this population of patients with ACS, iron metabolism alterations were associated with a higher occurrence of adverse events. Elevated ferritin levels were an independent predictor of long-term mortality. Serum iron levels did not constitute an independent risk factor for theoccurrenceof cardiovascular events. Additional studies are required to clarify whether serum iron or ferritin levels constitute a vascular injury/prognostic 148