SERUM IRON, FERRITIN AND TrtANSFERRIN IN PATIENTS WITH ISCHEMIC HEART DISEASE
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To shed more light on the relationship between ischemic heart disease and iron, serum iron parameters (iron, ferritin and transferrin) were estimated in fifty ischemic heart patients (15 stable angina, 15 crescendo angina and 20 acute Myocardial Infarction, MI). Their ages ranged 43 to 58 years. Ten healthy subjects, matched with patients for age and sex, served as control group. Echocardiographic studies (ejection fraction, (EF) and end systolic volume, (ESP) together with peak plasma creatine phosphokinase (CPK) were done for each case of infarction to correlate these variables with the corresponding serum iron parameters. Compared to controls, ischemic heart patients had highly significant increase of serum iron (103.5 1 25.6 vs. 79.6 1 19.2, p < 0.01) and serum ferritin (94.7 2 54.2 vs. 44.41 11.0, p < 0.01) where as they showed insignificant increase of serum transferrin (273.8 -1 83.8 vs 244 1 2 56.4. P > 0.05). Subgroup analysis showed that there was statistically significant increase in serum iron and ferritin but not transferrin in patients with stable angina and in patients with unstable angina while in cases with acute MI, there was significant increase in all serum iron parameters. Correlation studies showed that serum iron and ferritin but not transferrin were strongly correlated with peak CPK, EF and ESV. Patients with acute MI who had complicated in-hospital course showed significant higher value of iron, ferritin, transferrin, CPK and ESV but they had a significant lower EF than non-complicated cases. In conclusion, serum iron and ferritin were significantly higher in ischemic heart patients while serum transferrin was significantly higher only in patients with acute MI. In the infarction group, the higher the serum iron and ferritin, the larger is the size of infarction, the worser is the inhospial course and the more impaired is the systolic function. Thus, the present study might give a new meaning for the emerging role of iron in ischemic heart disease.