The relationship between serum hepcidin/ferritin ratio and clinical treatment efficacy in the patients with acute myocardial infarction and acute left heart failure

Huang Bin; Xu Qiuping

doi:10.3969/j.issn.1002-1949.2024.03.004

Abstract：Objective To explore the relationship between serum hepcidin/ferritin ratio and clinical treatment efficacy in the patients with acute myocardial infarction and acute left heart failure.Methods A total of patients with acute myocardial infarction complicated with acute left heart failure admitted to the Mianyang Central Hospital from January 2020 to May 2023 were divided into effective group and ineffective group according to the clinical treatment efficacy after one-week treatment.The changes of serum hepcidin,ferritin and hepcidin/ferritin ratio of the two groups were observed at admission and after one-week treatment,and the general data and other laboratory indicators including hemoglobin,high-sensitivity troponin,N-terminal pro-brain natriuretic peptide of the two groups were compared statistically.The relationship of serum hepcidin,ferritin and hepcidin/ferritin ratio at admission with the clinical treatment efficacy of patients was analyzed by point-biserial correlation analysis,and the value of serum hepcidin,ferritin and hepcidin/ferritin ratio at admission in predicting the treatment effect of patients was evaluated by receiver operating characteristic(ROC)curves.At the same time,another 68 patients with acute myocardial infarction complicated with acute left heart failure admitted to the hospital from May 2023 to October 2023 were selected as the validation objects.The predictive value of serum hepcidin/ferritin ratio in the treatment effect of patients was further verified through ROC curves.Results According to the inclusion and exclusion criteria,a total of 308 patients were selected as the study subjects in this study.Ultimately,303 patients completed the evaluation of treatment effectiveness,of which 257 patients(84.82%)were effective.The serum hepcidin and hepcidin/ferritin ratio in the ineffective group were higher than those in the effective group at admission and after one-week treatment,and the serum ferritin was lower(P<0.05).Compared with at admission,serum hepcidin and hepcidin/ferritin ratio decreased and serum ferritin level increased in the effective group after one-week treatment(P<0.05).However,there was no statistical significant difference in serum hepcidin,ferritin and hepcidin/ferritin ratio between at admission and after one-week treatment in the ineffective group(P>0.05).There was a statistical significant difference in the levels of high-sensitivity troponin,N-terminal pro-brain natriuretic peptide,and hemoglobin between the two groups at admission(P<0.05).The point-biserial correlation analysis found that the clinical treatment efficacy of patients was positively correlated with the serum hepcidin and hepcidin/ferritin ratio at admission(r>0,P<0.05),and was negatively correlated with the serum ferritin level at admission(r<0,P<0.05).The ROC curve found that serum hepcidin,ferritin,and hepcidin/ferritin ratio at admission had certain predictive value for the treatment effectiveness of patients,and the hepcidin/ferritin ratio had higher predictive value.The validated ROC curve results showed that the serum hepcidin/ferritin ratio at admission still had good predictive value for treatment effectiveness of the patients.Conclusions The serum hepcidin/ferritin ratio at admission in the patients with acute myocardial infarction and acute left heart failure is related to clinical treatment efficacy,which can assist in early prediction of treatment effectiveness and guide timely adjustment of treatment plans.