Abstract 4144918: Association of iron deficiency correction with the improvement of left ventricular systolic function in patients within 12 months after myocardial infarction

Background: The adverse effects of iron deficiency (ID) on left ventricular function and outcomes in patients with acute coronary syndrome have been established. However, the effects of ID and its treatment in patients with myocardial infarction (MI) have not been adequately studied. Aim: To study left ventricular systolic function, assessed by evaluation of the wall motion score index (WMSI) and left ventricular ejection fraction (LVEF), in patients with corrected ID and persistent ID within 12 months after MI. Methods: This is open prospective study. 100 patients, 53 males (53%), and 47 females (47%) hospitalized with MI in "Kazan city clinical hospital 7" were enrolled in 2022 year. The mean age was 62±13 years. All patients had ID. ID is assumed to be present when serum ferritin <100 ng/mL or 100 ng/mL ≤ serum ferritin ≤299 ng/mL with transferrin saturation<20%. All patients were treated with iron supplements. After 3 months iron status was evaluated again, and the patients were divided into 2 groups: Group 1 - 70 (70%) patients with corrected ID and group 2 - 30 (30%) patients with persistent ID after the treatment. Echocardiography is performed within 24 hours and 3, 6, 12 months after MI. Results: The groups did not differ in major clinical parameters, comorbidities, medications, laboratory parameters, including hemoglobin level. The median (Me) of WMSI in the 24 hours after admission was 1.25 [1.19;1.62] in group 1 and 1.25 [1.12;1.56] in group 2 (p=0.55). In group 1, the Me WMSI at 3 months remained unchanged (1.25 [1.19;1.5], p =0,5), and was significantly lower than baseline at 6 months (1.19 [1.06-1.56], p < 0.001) and at 12 months (1.12 [1.0;1.44], p < 0.001). In patients in group 2, the Me WMSI remained unchanged at 3 months (1.25 [1.03;1.5], p=0.5), 6 months (1.25 [1.03;1.5], p=0.8) and 12 months (1.25 [1.0;1.5], p=0.6)(Pic. 1). The Me LVEF in the 24 hours after admission was 48% [45;54] in group 1 and 53% [48;54] in group 2 (p=0.06). In group 1, the Me LVEF remained unchanged at 3 months (48% [46;54], p=0.25) and was significantly increased than baseline after 6 months (53% [45;58], p<0,001) and 12 months (55% [47;58], p<0,001). In group 2, LVEF remained unchanged at 3 months (53% [46;57], p=0.75), at 6 months (53% [47;57], p=0.2) and 12 months (53% [46;58], p=0.7). Conclusion: Corrected ID is associated with a significant improvement of left ventricular systolic function in comparison with persistent ID in patients within 12 months after MI.