Serum ferritin levels in patients with acute myocardial infarction: A hospital-based case–control study from a tertiary care center in south India

Background: Acute myocardial infarction (AMI) remains a leading cause of global morbidity, with rising burden in India despite conventional risk factors. Emerging evidence implicates iron metabolism and oxidative stress in atherogenesis. Serum ferritin, an iron-storage protein and acute-phase reactant, is increasingly investigated as a potential biochemical marker in cardiovascular disease. Objectives: The aim of this study is to evaluate serum ferritin levels in patients presenting with acute myocardial infarction, compare these levels with those of age- and sex-frequency-matched healthy controls, and examine their relationship with conventional cardiovascular risk factors.Methods: This hospital-based age- and sex-frequency-matched case–control study was conducted at a tertiary care teaching hospital in South India over a period of ۱۸ months. A total of ۸۰ participants were enrolled, including ۴۰ patients with confirmed acute myocardial infarction and ۴۰ apparently healthy controls. Serum ferritin samples were obtained at the time of initial clinical evaluation following admission. All participants underwent detailed clinical assessment, anthropometric evaluation, lipid profile analysis, and serum ferritin estimation using chemiluminescence immunoassay. Results: Mean serum ferritin levels were significantly higher in patients with acute myocardial infarction compared with controls (۲۰۹.۹ ± ۵۲.۸ ng/mL vs. ۸۶.۹ ± ۲۸.۶ ng/mL; p <۰.۰۰۱). Serum ferritin concentrations ≥۲۰۰ ng/mL were observed in ۵۷.۵% of AMI cases, whereas none of the controls demonstrated ferritin values within this range. In addition, elevated ferritin levels were more frequently observed in patients with higher body mass index, smoking history, dyslipidemia, diabetes mellitus, and hypertension. Conclusion: Serum ferritin levels were significantly elevated in patients with acute myocardial infarction and showed significant association with conventional cardiovascular risk factors. Given the acute inflammatory nature of myocardial infarction and the absence of inflammatory marker assessment, the observed ferritin elevation may reflect both altered iron metabolism and acute-phase inflammatory response. Therefore, serum ferritin should be interpreted as an associated marker rather than an independent diagnostic or causal biomarker of AMI. Larger prospective studies incorporating inflammatory markers and multivariable analyses are required to clarify its clinical and prognostic relevance.

کلیدواژه ها:

Serum ferritin ، Acute myocardial infarction ، Iron metabolism ، oxidative stress ، Inflammation