Abstract: Objective To evaluate the predictive value of serum iron level for in-hospital acute heart failure (AHF) after acute
ST-elevated myocardial infarction (STEMI). Methods This retrospective study involved 287 patients with STEMI stratified by
quartiles of admission serum iron concentration. The incidence of AHF was assessed by serum iron quartiles. We evaluated the
association of serum iron levels with B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), and high-sensitivity
C-reactive protein (hs-CRP) levels on admission, and analyzed the correlation of serum iron levels with in-hospital AHF, death,
and duration of hospital stay. Results The average serum iron level on admission of the 287 STEMI patients was 10.20 μmol/L
(6.90-14.40 μmol/L), and the quartiles (Q) of serum iron levels were ≤6.90 μmol/L (Q1), 6.91-10.19 μmol/L (Q2), 10.20-14.39 μmol/L
(Q3), and ≥14.40 μmol/L (Q4). The incidences of in-hospital AHF from Q1 to Q4 were 79.5% , 64.3% , 50.0% and 45.9% ,
respectively (P<0.001). Univariate logistic regression analysis showed that low admission serum iron level (Q1) was an
independent predictor for in-hospital AHF (OR=3.358, 95% CI 1.791- 6.294, P<0.001), and multivariate logistic regression
analysis showed a similar result (OR=2.316, 95%CI 1.205-4.453, P=0.012). Conclusion A lower admission serum iron level is an
independent predictor of AHF in STEMI patients during hospitalization.