Serum ferritin-a novel risk factor in acute myocardial infarction.

BACKGROUND A possible association between body iron status and risk of coronary heart disease (CHD) has been found to be controversial from the data obtained from various studies. OBJECTIVES To study the relationship of serum ferritin with acute myocardial infarction (AMI) in univariate and multivariate analysis and to assess the relationship of high serum ferritin with established conventional risk factors. METHODS Hospital based case-control study of 75 cases of AMI, and 75 age and equal number of age, and gender-matched controls without having AMI in the age group of 30-70 years. RESULTS Median serum ferritin levels were significantly higher in cases (220 μg/L) than controls (155 μg/L) (P ≤ 0.0001. In univariate analysis in addition to ferritin > 200 μg/L (odds ratio [OR] 6.71, 95% confidence interval [CI] = 3.22-12.89, P<0.05), diabetes (OR=7.68, 95% CI=2.95-19.13, P<0.05), hypertension (HTN) (OR=2.36, 95% CI=1.02-5.14, P<0.05) high-density lipoprotein (HDL) < 35 mg/dL (OR = 11.9, 95% CI = 2.66-52.57, P<0.05) and smoking (OR=2.17, 95% CI = 1.12-3.87, P< 0.05) were found to be significantly associated with AMI. After controlling for all conventional risk factors, in multiple logistic regression analysis, high ferritin was significantly associated with AMI. (adjusted OR=5.72, 95% CI=2.16-15.17, P < 0.001). Serum ferritin was significantly higher in diabetics than non-diabetics (P < 0.01). CONCLUSION High serum ferritin is strongly and independently associated with AMI.