Prognostic value of serum ferritin and iron metabolism subgroups for mortality in acute heart failure
Irish Journal of Medical Science, cilt.195, sa.1, ss.97-104, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 195 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11845-025-04199-6
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.97-104
- Anahtar Kelimeler: Heart failure, Iron deficiency, Ferritin, Mortality
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.