International Journal of Basic Medicine and Clinical Research, Vol 1, Issue 3, 2014 Page 72

Original Article
Relationship of Serum Ferritin with Acute Myocardial Infarction in different age groups
Ranjan Solanki
1*
Shipra Solanki
2

1*
Associate Professor, Department of Pathology, Muzaffarnagar Medical College.
2
Department of Biochemistry, Subharti Medical College, Meerut

*Corresponding Author email -solanki.ranjan@gmail.com

Abstract

Introduction - The incidence of Myocardial Infarction increases with age; however, the actual
incidence is dependent on predisposing risk factors for atherosclerosis. As the mean age of the
population increases, a larger percentage of patients presenting with MI will be older than 65
years. Ferritin is a globular, intracellular protein that stores iron and releases it in a controlled
fashion. Since serum Ferritin concentration is directly proportional to intracellular ferritin
concentration, it is considered to be the best clinical measure of body iron store and the most
feasible to use in epidemiologic studies.
Aim The aim of the study was to estimate serum ferritin level in patients of AMI in different
age groups.
Material and methods - All the patients who attended to medicine and emergency department
of Subharti medical college with the complaints suggesting Acute MI were evaluated. A total of
50 patients and 50 controls were studied. Lipid profile and serum ferritin levels of these patients
and control were estimated.
Results - We found that 16% of the patients of AMI were between 40-50 years of age, 34% were
between 50-60 years and 50% of the patient between 60-70 years. The highest incidence of AMI
occurred in elderly i.e., 60-70 years. Patients suffering from AMI were having higher serum
ferritin level ie; 268.4330.17
Conclusion- Serum ferritin levels were found to be significantly increased in the patients of MI
of all age groups as compared to controls.
Keywords Myocardial Infarction, Ferritin, Lipid profile
Received on 10-07-14 Accepted on 11-08-14
International Journal of Basic Medicine and Clinical Research, Vol 1, Issue 3, 2014 Page 73

Introduction
Myocardial infarction (MI) commonly known as heart attack is the interruption of blood supply
to a part of the heart causing heart cells to die, most commonly due to blockage of coronary
artery. Classical symptoms are sudden chest pain [typically radiating to left arm or left side of
the neck], shortness of breath, nausea, vomiting, palpitation, sweating and anxiety. Acute MI
(AMI) remains a leading cause of morbidity and mortality worldwide
1
. MI occurs when
myocardial ischemia, a diminished blood supply to the heart, exceeds a critical threshold and
overwhelms myocardial cellular repair mechanisms designed to maintain normal operating
function and homeostasis. Ischemia at this critical threshold level for an extended period results
in irreversible myocardial cell damage or death
2
.
India has the highest incidence of heart related diseases in the world and the number of those
affected is likely to double in the coming years, said by a leading cardiologist. "If no initiative
is taken to check the disease, the most predictable and also preventable among all chronic
diseases, India will have 62 million patients with heart disease by 2015, compared to 16 million
in the US,"
3.
The rate of heart attacks among Indians younger than 45 years of age in the last
three years was five times higher than in other populations. Indians who go abroad run the risk of
getting heart attacks four times more than others.
The incidence of MI increases with age; however, the actual incidence is dependent on
predisposing risk factors for atherosclerosis. Approximately 50% of all MIs in the United States
occur in people younger than 65 years. However, in the future, as demographic shift and the
mean age of the population increases, a larger percentage of patients presenting with MI will be
older than 65 years
4,5
.
Ferritin is a globular, intracellular protein that stores iron and releases it in a controlled fashion.
The amount of ferritin stored reflects the amount of iron stored. The protein is produced by
almost all living organisms, including algae, bacteria, higher plants, and animals
6
.
Since SF concentration is directly proportional to intracellular ferritin concentration, it is
considered to be the best clinical measure of body iron store
7
and the most feasible to use in
epidemiologic studies
8
.
Free radicals (FR), especially the hydroxyl radical (OH ) are extremely reactive and initiate
tissue damage and lipid peroxidation (LP)
9.
Consequently, when excess iron is consumed and
transferrin becomes saturated, free iron can be released. The production of FR by free iron has
been found in some studies to cause oxidative damage to the coronary arteries, and possibly
oxidize LDL-c, resulting in even more coronary damage
10.

Materials and Methods
The study was conducted from 11 Oct 2011 to 25 Aug 2013. A total of 50 patients of MI with
complaints of acute chest pain, attending to Medicine and Emergency Department of Chhatrapati
Shivaji Subharti Hospital, Subharti Medical College, Meerut were selected and 50 controls were
selected for the study. Application was moved for ethical clearance from the Institutional Ethical
Committee. In the mean while, patients consent form and Data Collection Tickets (DCT) were
designed and sufficient copies prepared. Working on this topic was started after receiving ethical
clearance from the Institutional Ethical Committee dated: 11 Nov 2011. Informed consent was
taken from each individual patient/attendant.
Lipid profile including total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), low
density lipoprotein cholesterol (LDL-c), very low density lipoprotein cholesterol (VLDL-c) and
triglyceride (TG) levels were estimated in Vitros-250 auto analyzer using readymade dry
International Journal of Basic Medicine and Clinical Research, Vol 1, Issue 3, 2014 Page 74

chemistry kits procured from Ortho- Clinical Diagnostics, Johnson & Johnson, USA. Serum
Ferritin was estimated by enzyme linked fluorescent assay (ELFA) on MINIVIDAS auto
analyzer (Biomerieux) in all 100 subjects.
All the data so collected were duly recorded and was compiled; results & observations drawn
and statistically analyzed using Mean, Standard deviation, Anova, unpaired Studentst test, Chi-
square test and Z test.
Results and Observations:
In our study we have found that 16% of the patients of AMI were between 40-50 years of age
and around 34% were between 50-60 years and 50% of the patient were between 60-70 years of
age. The highest incidence of AMI occurred in elderly i.e., 60-70 years.

Table 1: Distribution of subjects according to their age
Age (yr.) Study (n=50) Control (n=50)
40-50 8 (16%) 10 (20%)
50-60 17 (34%) 22 (44%)
60-70 25 (50%) 18 (36%)

Patients suffering from AMI were having higher serum ferritin level ie; 268.4330.17

Table-2: Serum ferritin levels in different groups and its statistical significance
GROUP AGE DISTIBUTION MEANSD t-value p-value
STUDY GROUP
40-50yrs, (n=8) 267.75 31.7 4.91 <0.01(SIG.)
50-60yrs, (n=17) 250.52 41.21 8.21 <0.01(SIG.)
60-70yrs, (n=25) 264.1631.87 14.99 <0.01(SIG.)
Total, (n=50) 268.4330.17 17.43 <0.01(SIG.)
CONTROL
GROUP
40-50yrs, (n=10) 125.4 76.39
50-60yrs, (n=22) 109.95 60.52
60-70yrs, (n=18) 104.1637.99
Total, (n=50) 110.9656.59

Discussion
The incidence of coronary artery disease (CAD) is alarmingly increasing in our country, Reddy
and Yusuf concluded that 2.39 million people died of CAD in 1990 in India and hypothesized
that the number may double by the year 2015
11
.
We found MeanS.D of serum ferritin levels in the study group 268.4330.17; while
110.9656.59 in the control group. We calculated the statistical significance of SF by applying
students t-test and found that these values in study group were statistically highly significant
International Journal of Basic Medicine and Clinical Research, Vol 1, Issue 3, 2014 Page 75

(p<0.01) when compared with that of control group. Our findings are in agreement with the
findings of Silvia et al (2003)
12
, whose MeanS.D. SF level was 257.3576.34 g/L in the MI
patients of their study group and; 155.4274.10 g/L in the control group.
Haidari (2001)
13
reported that increased ferritin might be an independent predictor of premature
CAD in male Iranian patients. Ferritin was higher in the male & female patients with MI than in
the male & female subjects without MI.
Conclusion
Serum ferritin levels were found to be significantly increased in the patients of MI of all age
groups as compared to controls.

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