Iron deficiency and long-term mortality in elderly patients with acute coronary syndrome

Aim: We evaluated the relationship between iron deficiency (ID) and long-term mortality risk in elderly patients with acute coronary syndrome (ACS). Methods: In this prospective observational study, we included 252 patients older than 65years with ACS. Transferrin saturation (TSAT) and ferritin were collected before discharge. Results: Mean age, hemoglobin and GRACE score were 787years, 12.4 +/- 1.8g/dl and 138.8 +/- 25.3, respectively, 112(44.4%) patients were women, and 151(59.9%) presented ID. During the follow-up, 121 (48%) patients died. Mortality rates among TSAT quartiles were: 2.38, 1.60, 0.90 and 0.95x10 person-years for Q1TSAT to Q4TSAT, respectively (p<0.001) and did not differ across ferritin quartiles (p=0.601), whereas ID definition was borderline associated (p=0.060). Adjusted TSAT levels remained inverse, nonlinearly associated with long-term mortality risk (p<0.001), with an exponential increased-risk from values about 20% and below. Conclusion: Lower TSAT levels were independently associated with increased mortality risk in these patients.