Investigation of the impact of iron deficiency anemia on the clinical outcome of hospitalized patients and the 6-month outcome of acute STEMI patients undergoing primary angioplasty

Background: Acute myocardial infarction (MI), particularly ST-elevation myocardial infarction (STEMI), is a severe form of acute coronary syndrome often resulting from complete coronary artery occlusion. Iron deficiency (ID) is a prevalent nutritional disorder worldwide and may influence cardiovascular outcomes, including in STEMI patients. This study aimed to assess the impact of ID on left ventricular function and clinical outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods: This prospective study included 257 patients with acute STEMI admitted to Shahid Madani hospital in Tabriz between October 2020 and October 2022. Patients who presented within 12 hours of chest pain onset and met the inclusion criteria were categorized into two groups based on the presence or absence of ID, defined by serum ferritin levels <100 mg/dL or transferrin saturation<20%. Comprehensive demographic, clinical, and angiographic data were collected. The primary outcomes assessed were the occurrence of major adverse cardiovascular events (MACE), thrombolysis in myocardial infarction (TIMI) flow grading, and enzymatic infarct size during hospitalization and at 6-month follow-up. Findings: ID was present in 54.4% of the patients. No significant differences were observed between the ID and non-ID groups regarding age, gender, body mass index (BMI), prevalence of comorbidities, or baseline left ventricular ejection fraction (LVEF). Additionally, the incidence of in-hospital and 6-month MACE, TIMI flow after PPCI, and enzymatic infarct size did not differ significantly between the two groups. However, serum iron, transferrin saturation, and ferritin levels were significantly lower in the ID group. Conclusion: Although ID was common among STEMI patients undergoing PPCI, it did not significantly affect in-hospital or 6-month outcomes. These findings suggest that ID may not be a crucial determinant of prognosis in STEMI patients, but further large-scale studies are needed to corroborate these results.