Introduction Iron deficiency (ID) is a well-known factor that worsens symptoms severity in heart failure. Available literatures showed that ID is also associated with worse adverse outcome in acute coronary syndrome (ACS), however data on its impact on clinical severity and relation with atherosclerotic plaque burden especially in ST elevation myocardial infarction (STEMI) remain underexplored.

Objective The study aims to assess the prevalence of ID in STEMI patients and its association with clinical severity and atherosclerotic plaque burden.

Material and Method This is a single-centre cross sectional study conducted on patients diagnosed with STEMI between April and May 2024. All the required information including comorbidities, transferrin saturation ratio and ferritin level were collected from electronic medical record. Clinical severity scores were calculated using TIMI and GRACE score. Atherosclerotic plaque burden was calculated using Gensini score.

Results The study included 37 patients and showed ID was prevalent in 78.4% of the study population (n=29). With regards to baseline comorbidities, only chronic kidney disease was found to be significantly different between ID and non ID patients (p=0.02). Chi-square test of clinical severity revealed no significant difference between both groups, TIMI score ID = 4.5 ± 2.7, non-ID = 4.6 ± 3.3, p=0.90 ; and GRACE score ID = 159.5 ± 43.5, non-ID = 172.9 ± 47.9, p=0.33. Additionally, linear regression analysis found no association between iron status and Gensini score (p=1.00).

Discussion The study findings suggest that while ID is common among STEMI patients, it may not significantly impact clinical severity as measured by TIMI, GRACE and Gensini score. However, ID is still important to be managed in STEMI patients as literatures have proven that ID carry poor prognosis in STEMI population. The contrast findings could be due to small sample size and not consider other subtypes of ACS.

Conclusion ID status does not appear to be associated with clinical severity in STEMI patients. Further researches with larger sample size and more robust methodology are required to further understand the link.