Iron deficiency for prognosis in acute coronary syndrome - A systematic review and meta-analysis

Int J Cardiol. 2021 Apr 1:328:46-54. doi: 10.1016/j.ijcard.2020.12.021. Epub 2020 Dec 14.

Abstract

Background: Iron deficiency (ID) is an important predictor of adverse outcomes in patients with heart failure, however it is unclear whether ID also affects prognosis in patients with acute coronary syndrome (ACS). The aim of this systematic review and meta-analysis was to assess the prognostic value of iron deficiency in patients with ACS.

Methods: We searched PubMed, Web of Science, and the Cochrane library and included cohort studies of patients with ACS that were stratified by ID status. There were no restrictions on definition of ACS or ID. Studies were systematically appraised and data extracted by two independent reviewers. Meta-analysis was performed where two or more studies reported on the same pre-determined outcome measure.

Results: Seven studies with 2821 participants were identified, reporting a high prevalence of ID in the ACS population. Three studies reported worse long-term outcomes in the ID population, whereas short-term outcomes were heterogeneous across studies.

Conclusions: Patients with ID presenting with ACS may have a worse long-term prognosis but more studies are required for confirmation. A role for ID in prognosis of patients with ACS and as a potentially treatable condition may have implication for the current management of this patient population.

Keywords: Acute coronary syndrome; Iron deficiency; Meta-analysis; Myocardial infarction; Prognosis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Acute Coronary Syndrome* / diagnosis
  • Acute Coronary Syndrome* / epidemiology
  • Anemia, Iron-Deficiency* / diagnosis
  • Anemia, Iron-Deficiency* / epidemiology
  • Cohort Studies
  • Heart Failure*
  • Humans
  • Prognosis