Publication:

Assessment of ferritin and its association with C - reactive protein and malondialdehyde in acute myocardial infarction

Background There is increasing evidence that moderately elevated body iron stores, below levels commonly found in genetic hemochromatosis, may be associated with adverse health outcomes. Ferritin status has been implicated in atherosclerotic cardiovascular disease and hypothesis is that high iron status is associated with increased oxidation of LDL. The main objective of study is to evaluate the ferritin status and its association with C - reactive protein, malondialdehyde and serum lipids in acute myocardial infarction patients compared with healthy volunteers.

Methods Sixty seven acute myocardial infarction (AMI) patients in the age group of 30 to 50 years were selected for this study and 40 healthy age matched subjects were selected as control group. Diagnosis of AMI was made using guidelines of American College of Cardiology and European Society of Cardiology. The comprised group of 67 consecutive patients was divided based on the C - reactive protein (CRP) level into two groups (Group I <5 mg/L and Group II ≥5mg/L). Serum ferritin was assessed by ELISA method, C-reactive protein by turbilatex method and malondialdehyde (MDA) by Thiobarbituric Acid Reactive Substances (TBARS) method. Routine investigations were analysed by ERBA EM-360 fully automated analyzer.

Results The mean serum ferritin level was significantly increased in AMI patient groups compared with controls. The group II patients showed significantly increased serum ferritin levels compared to group I. In both the groups ferritin levels positively correlated with CRP and malondialdehyde. In group II serum ferritin levels showed positive correlation with serum Cholesterol, TGL, LDL and negative correlation with and HDL.  In group I serum ferritin levels showed positive correlation with triglycerides and LDL and there was no statistical significant correlation with HDL and total cholesterol.

Conclusions Iron, an essential dietary constituent is now considered as a pro oxidant. Higher levels of ferritin, seems to be a strong risk factor for AMI. Regular monitoring of serum ferritin level can be useful in reducing cardiovascular morbidity and mortality.