Key result
Among critically ill patients with atrial fibrillation, being in the highest ferritin quartile was associated with a 27.7% increased risk of 1-year all-cause mortality compared to the lowest quartile.
Why the study?
Perturbations in iron homeostasis can substantially affect cardiovascular outcomes, but their prognostic value for all-cause mortality in critically ill AF patients was unclear.
Does the baseline level of ferritin and other iron homeostasis indicators predict 1-year all-cause mortality in critically ill patients with atrial fibrillation?
Cohort (n=4,949)
No
Does the baseline level of ferritin and other iron homeostasis indicators predict 1-year all-cause mortality in critically ill patients with atrial fibrillation?
Answers are grounded in this paper and cite their sources.
Ferritin, transferrin, and TIBC levels upon ICU admission may serve as independent prognostic markers for 1-year mortality in critically ill patients with atrial fibrillation.
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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Wu et al. (2026) conducted a cohort in Atrial Fibrillation in Intensive Care Unit (n=4,949). Highest quartile of ferritin vs. Lowest quartile of ferritin was evaluated on 1-year all-cause mortality (HR 1.277, 95% CI 1.083-1.506, p=< 0.01). Among critically ill patients with atrial fibrillation, being in the highest ferritin quartile was associated with a 27.7% increased risk of 1-year all-cause mortality compared to the lowest quartile.
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