Implications of Iron Deficiency in STEMI Patients and in a Murine Model of Myocardial Infarction

In patients with a first anterior ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention, iron deficiency (ID) was associated with larger infarcts, more extensive microvascular obstruction, and higher frequency of adverse left ventricular remodeling as assessed by cardiac magnetic resonance imaging. In mice, an ID diet reduced the activity of the endothelial nitric oxide synthase/ soluble guanylate cyclase/protein kinase G pathway in association with oxidative/nitrosative stress and increased infarct size after transient coronary occlusion. Iron supplementation or administration of an sGC activator before ischemia prevented the effects of the ID diet in mice. Not only iron excess, but also ID, may have deleterious effects in the setting of ischemia and reperfusion. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Automated summary

Iron deficiency is associated with adverse left ventricular remodeling and larger infarct size in patients with anterior ST-segment elevation myocardial infarction. Studies in mice show that an iron deficiency diet reduces the activity of the endothelial nitric oxide synthase pathway, leading to oxidative stress and increased infarct size. Iron supplementation or sGC activators can prevent the negative effects of iron deficiency in mice.