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Objective <p>This study aimed to investigate the association between iron metabolism–related parameters and in-hospital mortality in patients presenting to the emergency department (ED) with symptoms and signs of acute heart failure (AHF), and to determine the prognostic value of iron metabolism–related subgroups.</p> Methods <p>This prospective observational case series was conducted in the ED of a tertiary hospital between May 1, 2023, and February 29, 2024. A total of 941 patients who presented with AHF and met the inclusion criteria were evaluated. Demographic, clinical, and laboratory data were recorded, and their associations with short-term mortality were analyzed statistically. Serum ferritin levels and transferrin saturation (TSAT) values were classified to define subgroups of iron metabolism.</p> Results <p>In-hospital mortality occurred in 13.8% of the patients (<i>n</i> = 130). Logistic regression analysis identified ferritin levels as an independent predictor of mortality. Patients with ferritin levels of 100–299 ng/mL had a 5.8-fold increased risk of mortality, while those with ferritin ≥ 300 ng/mL had a 13.6-fold increased risk (both <i>p</i> &lt; 0.001). In ROC analysis, ferritin was the strongest biomarker for predicting mortality, with an AUC of 0.811 (95% CI: 0.774–0.848). At the determined cut-off value of 102.8 ng/mL, ferritin demonstrated a sensitivity of 74.5% and specificity of 75.2%. In Group 3 (ferritin ≥ 300 ng/mL + TSAT &lt; 20%), the mortality rate was 42.5% (<i>p</i> &lt; 0.001).</p> Conclusion <p>Elevated ferritin levels provide additional prognostic value for early risk stratification and may help identify high-risk subgroups among patients presenting to the emergency department with acute heart failure.</p>

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Prognostic value of serum ferritin and iron metabolism subgroups for mortality in acute heart failure

  • 期刊论文

  • 发表日期：

    2025年11月29日

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  • Ali İsa Aslan,
  • Salim Satar,
  • Selen Acehan,
  • Muge Gulen,
  • Atilla Bulut,
  • Sarper Sevdimbas,
  • Kadir Nigiz,
  • Mehmet Gorur

摘要

Objective

This study aimed to investigate the association between iron metabolism–related parameters and in-hospital mortality in patients presenting to the emergency department (ED) with symptoms and signs of acute heart failure (AHF), and to determine the prognostic value of iron metabolism–related subgroups.

Methods

This prospective observational case series was conducted in the ED of a tertiary hospital between May 1, 2023, and February 29, 2024. A total of 941 patients who presented with AHF and met the inclusion criteria were evaluated. Demographic, clinical, and laboratory data were recorded, and their associations with short-term mortality were analyzed statistically. Serum ferritin levels and transferrin saturation (TSAT) values were classified to define subgroups of iron metabolism.

Results

In-hospital mortality occurred in 13.8% of the patients (n = 130). Logistic regression analysis identified ferritin levels as an independent predictor of mortality. Patients with ferritin levels of 100–299 ng/mL had a 5.8-fold increased risk of mortality, while those with ferritin ≥ 300 ng/mL had a 13.6-fold increased risk (both p < 0.001). In ROC analysis, ferritin was the strongest biomarker for predicting mortality, with an AUC of 0.811 (95% CI: 0.774–0.848). At the determined cut-off value of 102.8 ng/mL, ferritin demonstrated a sensitivity of 74.5% and specificity of 75.2%. In Group 3 (ferritin ≥ 300 ng/mL + TSAT < 20%), the mortality rate was 42.5% (p < 0.001).

Conclusion

Elevated ferritin levels provide additional prognostic value for early risk stratification and may help identify high-risk subgroups among patients presenting to the emergency department with acute heart failure.