Document Detail

Prognostic Evaluation of Catalytic Iron in Patients With Acute Coronary Syndromes.
MedLine Citation:
PMID:  23377899     Owner:  NLM     Status:  Publisher    
BACKGROUND: The potential of iron to generate reactive oxygen species has motivated a long-standing interest in whether excess iron is causally linked to atherosclerotic heart disease. Circulating catalytic iron ("free" iron) is that which is not bound to transferrin or ferritin and is available to generate reactive oxygen species that may have deleterious vascular effects. HYPOTHESIS: We hypothesized that increased levels of catalytic iron would be associated with increased cardiovascular events. METHODS: We investigated the association of catalytic iron with clinical outcomes in 1701 patients with unstable angina, non-ST-segment elevation myocardial infarction (MI), or ST-segment elevation MI who were followed for a median of 10 months. All endpoints were adjudicated by a blinded Clinical End Points Committee. RESULTS: The median catalytic iron level was significantly higher in those who died, 0.45 µmol/L (0.37, 0.57), compared with survivors, 0.37µmol/L (0.31, 0.46; P = 0.016). Catalytic iron was associated with a stepwise increased risk of death, with the highest quartile at an almost 4-fold risk compared with baseline (hazard ratio: 3.94, P = 0.035), which persisted after adjustment for age, diabetes, prior MI, prior congestive heart failure, ST-segment deviation, creatinine clearance, B-type natriuretic peptide, smoking, and Killip class (adjusted hazard ratio: 3.97, P = 0.036). There was no association between catalytic iron and risk of MI, recurrent ischemia, heart failure, or bleeding. CONCLUSIONS: Increasing catalytic iron levels were associated with increased all-cause mortality. Although our findings suggest that catalytic iron is not likely to add to available tools as a routine biomarker for risk stratification of recurrent ischemic events, its association with mortality is intriguing and leaves open the question of whether cardiovascular therapeutics aimed at catalytic iron may be useful. The TIMI Study Group has received research grant support from the Muljibhai Patel Society for Research in Nephro-Urology. There are no other financial relationships, or conflicts of interest relevant to this manuscript to disclose.
Dylan L Steen; Christopher P Cannon; Suhas S Lele; Mohan M Rajapurkar; Banibrata Mukhopadhyay; Benjamin M Scirica; Sabina A Murphy; David A Morrow
Related Documents :
23489879 - Ridge-related reentry: a variant of perimitral atrial tachycardia.
23415169 - Vitamin d and prognosis in acute myocardial infarction.
9708469 - Efficacy of augmented immunosuppressive therapy for early vasculopathy in heart transpl...
16759719 - Whole heart coronary magnetic resonance angiography for the detection of coronary arter...
16479639 - Evaluation of cardiac function and myocardial viability with 16- and 64-slice multidete...
21719549 - Intraoperative transesophageal echocardiography and ventricular assist device insertion.
20436059 - Acute heart failure due to transient left ventricular dyssynchrony: case study.
9588409 - Admission clinical and electrocardiographic characteristics predicting an increased ris...
8934519 - Inhibition of myocardial endothelin pathway improves long-term survival in heart failure.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-3
Journal Detail:
Title:  Clinical cardiology     Volume:  -     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Wiley Periodicals, Inc.
TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA.,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Congenital heart defects and major structural noncardiac anomalies in Alberta, Canada, 1995-2002.
Next Document:  The anterior insular and anterior cingulate cortices in emotional processing for self-face recogniti...