Association of Iron Homeostasis With One-Year All-Cause Mortality Among Intensive Care Unit Patients with Atrial Fibrillation: A Retrospective Study

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2026-10-14 DOI:10.1002/clc.70494

Mingze Wu, Juan Hua, Yao Zhou, Yu Zhang, Lin Zhang, Yu Wang, Qinmei Xiong

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引用次数: 0

Abstract

Background

Perturbations in iron homeostasis can substantially affect cardiovascular outcomes. This study aims to evaluate the prognostic value of various iron homeostasis indicators for all-cause mortality in critically ill AF patients.

Method

Data for this retrospective study were obtained from the Medical Information Mart for Intensive Care IV database. Based on the iron homeostasis-related indicators (ferritin, serum iron, transferrin, and total iron-binding capacity [TIBC]), the risks of 1-year mortality among critically ill patients with atrial fibrillation were calculated using Cox proportional-hazards regression. Associations of iron homeostasis indicators with all-cause mortality in critically ill AF patients were assessed via Kaplan–Meier curves, restricted cubic splines, and subgroup analyses.

Results

After multivariable adjustment, patients in the highest ferritin quartile had a greater risk of 1-year mortality than those in the lowest quartile (Q4 HR 1.277, 95% CI 1.083−1.506, p < 0.01). In contrast, the highest quartiles of transferrin (Q4 HR 0.732, 95% CI 0.622−0.861, p < 0.01) and TIBC (Q4 HR 0.732, 95% CI 0.622−0.861, p < 0.01) were associated with lower mortality. No significant association was observed between serum iron quartiles and 1-year mortality (Q4 HR 1.067, 95% CI 0.914−1.245, p = 0.41). Restricted cubic spline analyses further characterized the exposure and outcome patterns for these iron-related parameters.

Conclusion

Among critically ill patients with AF, ferritin, transferrin and TIBC levels were independently associated with 1-year all-cause mortality. No significant association was observed for serum iron.

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在重症监护病房房颤患者中，铁稳态与一年全因死亡率的关系：一项回顾性研究

背景：铁稳态的扰动可以显著影响心血管结局。本研究旨在评估各种铁稳态指标对危重AF患者全因死亡率的预后价值。方法：本回顾性研究的数据来自重症监护医学信息市场IV数据库。基于铁稳态相关指标（铁蛋白、血清铁、转铁蛋白、总铁结合能力[TIBC]），采用Cox比例风险回归计算危重心房颤动患者1年死亡风险。通过Kaplan-Meier曲线、受限三次样条和亚组分析评估危重房颤患者铁稳态指标与全因死亡率的关系。结果：经多变量调整后，铁蛋白水平最高的四分位数患者1年死亡风险高于最低四分位数患者（Q4 HR 1.277, 95% CI 1.083-1.506, p）。结论：在危重AF患者中，铁蛋白、转铁蛋白和TIBC水平与1年全因死亡率独立相关。血清铁含量无显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.