Effect of serum ferritin on the prognosis of patients with coronary heart disease combined with heart failure
摘要
To study the effect of serum ferritin (SF) on the prognosis of patients with coronary artery disease combined with heart failure.
MethodsWe retrospectively included 3,424 adult patients with combined coronary artery disease (CAD) and chronic heart failure (CHF) from an initial screening of 4,442 patients. Inclusion criteria were age ≥ 18 years, presence of CAD (≥ 50% stenosis of major vessels) confirmed by angiography, and fulfillment of the European Society of Cardiology (ESC) guidelines for the diagnosis of CHF. One thousand one hundred and eight patients who might interfere with the primary outcome were excluded, including those with comorbid advanced cancer, severe organ dysfunction, immune or psychiatric disorders, and those with recent major trauma/surgery. Patients were categorized into a high SF group (≥ 230.465 ng/ml) versus a low SF group (< 230.465 ng/ml) based on the optimal threshold value of serum ferritin (SF). Clinical data were collected for between-group comparison and all-cause mortality assessment. Kaplan–Meier curves were used for survival analysis and differences between groups were compared by log-rank test; multivariate Cox regression analysis was also applied to screen independent risk factors affecting patients’ prognosis.
ResultCompared with the group with low SF values, the percentage of men, all-cause mortality, and B-type Natriuretic Peptide (BNP) were higher in the group with high SF values than in the group with low SF values (P < 0.05); After adjusting for potential confounders, the multivariable Cox regression analysis identified that age, albumin, and high-density lipoprotein were independent factors affecting survival risk, and the high SF group had a 47% higher risk of events compared to the low SF group. (HR:1.472, 95%CI: 1.174–1.846 P = 0.001).
ConclusionSF is an important prognostic biomarker in patients with coronary artery disease combined with heart failure, independent of traditional risk factors, and elevated SF levels are associated with poor prognosis in patients with coronary artery disease combined with heart failure.