Evidence of non-transferrin-bound iron in patients with ST-elevation myocardial infarction: relationship with microvascular obstruction and post-reperfusion myocardial hemorrhage

Background Hereditary hemochromatosis, thalassemia and myelodysplastic sindromes represent iron toxicity models with evidence of iron-related heart failure. Non-TransferrinBound Iron (NTBI), plays a key role in the pathogenesis of cardiac toxicity leading to the production of reactive oxygen species which increase lipid peroxidation (MDA). In acute myocardial infarction (MI) microvascular obstruction (MVO) and hemorrhage (HEM) are independent predictors of left ventricular (LV) remodelling. HEM may be a source of iron toxicity through NTBI and pro-inflammatory mediators (IL-6) , which can directly contribute to acute impairment of myocardial function and adverse LV remodelling. The aim of the study was to assess NTBI in a consecutive cohort of patients (pts) prospectively enrolled with ST-elevation MI (STEMI).and its relationship with MVO and HEM.