Association between Iron Metabolism and Myocardial Fibrosis in Patients with Coronary Heart Disease

WU Yu; WANG Wei; ZHOU Mo

doi:10.12102/j.issn.1672-1349.2025.20.016

Abstract：Objective: To investigate the association between iron metabolism and myocardial fibrosis in patients with coronary heart disease. Methods: A total of 59 patients diagnosed with coronary heart disease in our hospital's cardiology department from December 2020 to April 2022 and 90 patients without coronary heart disease were selected. Basic characteristics of the patients, including age, gender ratio, smoking status, body mass index (BMI), hypertension, N-terminal B-type natriuretic peptide (NT-proBNP), serum creatinine (Cr), and diabetes status, were recorded. Cardiac structure and function indicators during hospitalization [left ventricular end-diastolic diameter (LVEDD), left ventricular shortening fraction (LVFS), left ventricular ejection fraction (LVEF)] were also collected. Five milliliters of blood samples were collected, and levels of ferritin, serum iron, collagen type I, collagen type III, and alpha-smooth muscle actin (α-SMA) in peripheral venous plasma were detected using enzyme-linked immunosorbent assay (ELISA). Results: Compared with patients without coronary heart disease, patients with coronary heart disease showed significantly higher levels of serum ferritin, NT-proBNP, collagen type I, collagen type III, α-SMA, Cr, and LVEDD, while LVFS and LVEF were significantly lower. Ferritin levels were positively correlated with NT-proBNP, collagen type I, collagen type III, α-SMA, and LVEDD, and negatively correlated with LVFS and LVEF. Multivariate logistic regression analysis showed that both ferritin and NT-proBNP were independent predictors of coronary heart disease. Receiver operating characteristic (ROC) curve analysis indicated that NT-proBNP, ferritin, and their combination could predict the occurrence of coronary heart disease. The combination of ferritin and NT-proBNP had a higher specificity in predicting coronary heart disease than either alone. Conclusion: Serum ferritin levels are significantly elevated in patients with coronary heart disease and can serve as a key predictive factor for myocardial fibrosis and prognosis in these patients.