Relationship of Acute ST-Elevation Myocardial Infarction with hs-CRP and Serum Iron Profile in Southern India: A Cross-sectional Study

Abstract

Introduction: Cardiovascular diseases are a major cause of mortality. The role of Iron in oxidative myocardial damage remains controversial with multiple studies showing positive and negative correlations. Systemic inflammation is also an important factor in Myocardial Infarction (MI) with high sensitive C-Reactive Protein (hs-CRP) being an important marker. Aim: To investigate the relationship of serum iron and hs-CRP in patients diagnosed with ST-segment Elevation Myocardial Infarction (STEMI) and its role as prognostic indicators. Materials and Methods: A cross-sectional hospital-based study was conducted in which 45 patients were enrolled over a period of two months. Primary variables studied were STEMI and site of infarction as confirmed on echocardiography, hospital stay and patient outcome. Secondary variables were serum iron, hs-CRP, Total Iron Binding Capacity (TIBC), ferritin. Statistical analysis was done using IBM Statistical Package for the Social Sciences (SPSS) software version 20. Mann-Whitney U test, Kruskal Wallis test, ANOVA and Spearman’s rank correlation was used. Results: Iron profile was significantly altered in the various types of MI. Serum iron values lower than 61 mg/dL had a sensitivity of 89% and high Negative Predictive Value (NPV) (95%) for the prediction of mortality in patients. It was seen that significantly lower Unbound Iron Binding Capacity (UIBC) values were seen in patients who died than the survivor group. Low Transferrin Saturation (TS), serum iron, TIBC were associated with a longer hospital stay. About 42 patients showed hs-CRP levels above 0.3 mg/L. High hs-CRP and ferritin values were associated with a prolonged hospital stay. Conclusion: In patients with acute STEMI, serum iron and hs-CRP are shown to be important predictors of morbidity and mortality. Regular iron supplementation with a six monthly hs-CRP monitoring is recommended. Further research shows screening capability is needed.