Department of Cardiology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Nanjing University of Chinese Medicine, Nanjing, China.
Cardiovasc Toxicol. 2024 Oct;24(10):1018-1027. doi: 10.1007/s12012-024-09905-x. Epub 2024 Aug 2.
Iron deficiency (ID) is common in patients with acute myocardial infarction (AMI). It is unknown whether patients with AMI combined with ID will benefit from iron supplementation therapy. This study aimed to assess the relationship between iron therapy and mortality in AMI patients. Retrospective analysis was performed in subjects screened from the Medical Information Mart in Intensive Care-IV database. The data were obtained from ICU patients admitted to Beth Israel Deaconess Medical Center between 2008 and 2019. The patients were divided into two groups according to iron treatment exposure. Propensity score matching (PSM) was performed in the original cohort at a 1:1 ratio. Univariate and multivariate analyses were performed to adjust for confounding factors. The primary outcome was 28-day mortality. A total of 426 patients were included in this study. After 1:1 PSM, 208 patients were analyzed. Iron treatment was associated with a lower risk of 28-day mortality (9 deaths (8.65%) in the iron treatment group vs. 21 deaths (20.19%) in the non-iron treatment group; HR = 0.39; 95% CI = 0.17-0.89; p = 0.025) and in-hospital mortality (4 deaths (3.85%) in the iron treatment group vs. 12 deaths (11.54%) in the non-iron treatment group; OR, 0.15; 95% CI, 0.03-0.74; p = 0.029). Iron treatment was associated with reduced 28-day mortality in patients with AMI combined with ID. Iron treatment had no significant effect on the length of hospitalization or the length of ICU stay. Prospective studies are needed to verify this conclusion.
缺铁（ID）在急性心肌梗死（AMI）患者中很常见。目前尚不清楚合并 ID 的 AMI 患者是否会从铁补充治疗中获益。本研究旨在评估铁治疗与 AMI 患者死亡率之间的关系。从 Medical Information Mart in Intensive Care-IV 数据库筛选的受试者中进行回顾性分析。这些数据来自 2008 年至 2019 年期间入住 Beth Israel Deaconess Medical Center 的 ICU 患者。根据铁治疗暴露情况将患者分为两组。在原始队列中按 1:1 比例进行倾向评分匹配（PSM）。进行单因素和多因素分析以调整混杂因素。主要结局为 28 天死亡率。本研究共纳入 426 例患者。经过 1:1 PSM 后，分析了 208 例患者。铁治疗与 28 天死亡率降低相关（铁治疗组 9 例死亡（8.65%），非铁治疗组 21 例死亡（20.19%）；HR=0.39；95%CI=0.17-0.89；p=0.025）和院内死亡率（铁治疗组 4 例死亡（3.85%），非铁治疗组 12 例死亡（11.54%）；OR=0.15；95%CI=0.03-0.74；p=0.029）。铁治疗与合并 ID 的 AMI 患者 28 天死亡率降低相关。铁治疗对住院时间或 ICU 住院时间无显著影响。需要前瞻性研究来验证这一结论。
