Evaluation of Iron Profiles and Coagulation Profiles in Ischemic Heart Diseases Patients in Elmer Nimr Hospital, Sudan

Back ground chemic heart disease (IHD) isa constellation of diseases that includes stableangina,unstableangina,myocardialinfarction,andsuddencardiacdeath.It belongs to the group of cardiovascular diseases and is the most common type among them. Iron is an essential trace element .it plays an important role in maintaining various cellular function and enzymatic reactions. On the other hand, excessive intake of iron is known to be a risk factor for the progression of atherosclerosis. Abnormal iron deposition in the heart causes hem chromatists and dilated cardiomyopathy, which leads to is chemic heart disease .Objectives :This study aims to investigate the role of serum iron ,serum ferritin ,total iron-binding capacity(TIBC), PT, and PTT in is chemic heart disease(IHD)and their relationship with other risk factors for IHD This is a prospective, case-control, cross-sectional analytical study conducted


Introduction
Cardiovascular disease (CVD) is a type of disease that affects the heart, blood vessels(arteries, capillaries veins), or both Cardiovascular diseases refers to all diseases that affect the cardiovascular system, primarily heart disease, cerebral and renal vascular disease, and peripheral arterial disease.The causes of cardiovascular disease are varied, but other so sclerosis or hypertension are the most the risk of dying from(CAD) at a given age decreasedbetween1980and2010,especiallyindeveloped countries [8]The number of cases of (CAD) in a given age group alsodecreasedbetween1990and2010 [9].In the United States in 2010, approximately (20%)of (ages 65+) had (CAD (CAD),while(7%)and(1.3%) (Ages 45-64) (CAD) of (18-45 years old) Now.(10) More Mentha women at alienage [10].The Sudan H house hold Survey(SHHS)reported a prevalence of heart disease (2.5%).Hypert tensive heart disease(HHD),rheumatic heart diseases(RHD), ischemic heart disease(IHD),and cardiomyopathy account for more than (80%) of(CVD) in Sudan [6].Heart disease is the leading cause of morbidity and mortality yin Sudan.Hypertension (RHD), (IHD), and cardio myopathy account for the majority of four (CVD).Hyper tensions common and poorly controlled [11].Most cardiovascular diseases can be prevented by addressing risk factors such as to because, unhealthy diet obesity ,physical inactivity, hypertension, diabetes, and elevated lipids.More than half of the heart disease deaths in 2009 were men.Coronary heart disease (CHD)is the most common heart disease causing more than (385,000) deaths each year [6].Ischemic heartseases associated with progressive mechanical obstruction, dynamic obstruction, plaque inflammation, instability, and rupture, followed by super imposed thrombosis .Clinicians are employ in additional tools to aid clinical assessment and improve their ability to identify &quo that -risk &quote; patients who are at risk for cardiovascular disease [12,13].Bio mark arrasene of the tools to better identify at-risk individuals ,diagnose medical conditions quickly and a cure lately ,and effectively diagnose and treat sick patients.Biomarkers can be measured in biological samples (as blood, urine ,or tissue tests), can be human records (blood pressure, electrocardiogram, or holder), or imaging tests (echocardiogram).Normally very small amounts of iron are present tin most body cells, plasma ,and other extracellular fluids ,under body strictly limits its iron supply so that every day (0.1%)of the body&#39;s microcontents lost.maintain.Mainly in desquamated cells [14]Iron `s high activity is a two-Edged word, and free iron ions in the body also participate in destructive chemistry ,primary catalyzing the formation of toxic free radicals .Iron play role in the process of at hero sclerosis by catalyzing the formation of free radical and also this contributes to reperfusion Damage .High serum ferric tin concentration was associated with increased risk of my dial infarction, independent of major cardiovascular risk factors.Abnormal deposition of iron in the heart cause phenom at sis and dilated cardiomyopathy and this causes or imaging tests (echocardiogram).Normally very small amounts of iron are present tin most body cells, plasma, and other extracellular fluids ,under body strictly limits its iron supply so that every day (0.1%)of the body&#39;s microcontents lost.maintain.Mainly in desquamated cells [14]Iron `s high activity is a two-Edged word, and free iron ions in the body also participate in destructive chemistry ,primary catalyzing the formation of toxic free radicals .Iron play role in the process of at hero sclerosis by catalyzing the formation of free radical and also this contributes to reperfusion Damage .High serum ferric tin concentration was associated with increased risk of my dial infarction, independent of major cardiovascular risk factors.Abnormal deposition of iron in the heart cause phenom at sis and dilated cardiomyopathy and this causes causing is chemic heart disease [1].Coagulation play roe in is chemic heart disease ,increase plasm a level so coagulation in are associated with an increased risk of my ocarina infarction The orthro in time alone is derived from measures of prothrombin in ratio{PR}and intermate on abnormalized ratio{INR] are essays evaluating the extrinsic pathway bayan dc ammonal way of coagulation.They are used to determine the clotting tendency of blood in homes of war farinose [2].The role of blood clotting activation such as elevated circulating level of Amar cero fathom Bing enervation and fibro in peptide A in the occurrence of angina in I s chemic heart disease [3].Activated thromboplastin tin time issued to monitor the effects of the part non intrinsic pathways and detect defects in factors XII, XI, IX, VIII, and the common pathway .This study concluded that serum levels of iron ,ferret in ,TI, BC ,PT ,and PTT may be associated with is chemic heart disease.

common.
In addition, a variety of physiological and biochemical changes alter cardiovascular function in association with aging, leading to an increased risk of subsequent cardiovascular disease, even in healthy as symptom attic individuals.Cardiovascular disease is a leading cause of death.In 2008, 30% (30%) of all deaths worldwide were due to cardiovascular disease.Mortality from cardiovascular disease is also higher in low-and middle-income countries, as more than 80% of all cardiovascular deaths occur in these countries.It is also estimated that by 2030 more than 23 million people will die annually from card avascular disease [5,6].The causes, diagnosis prevention, control, and or treatment of all forms of cardiovascular disease continue to be an active area of biomedical research, with hundreds of scientific studies published each week.I'm here.In 2013, coronary heart disease (CHD) was the leading cause of death worldwide, with (8.14)million deaths(16.8%)compared with (5.74)million deaths(12%) in 1990.the risk of dying from(CAD) at a given age decreased between 1980 and 2010, especially in developed countries.The number of cases of(CAD) in a given age group alsodecreasedbetween1990and 2010.In the United States in 2010, approximately (20%)of (ages 65+) had (CAD) (CAD), while(7%)and(1.3%)(Ages 45-64) (CAD) of (18-45 years old) Now.(10) More Mentha women at alienage.The Sudan House hold Survey(SHHS)reported a prevalence of heart disease (2.5%).Hypertensive heart disease(HHD), rheumatic heart disease(RHD), ischemic heart disease(IHD), and cardiomyopathy account for more than (80%) of(CVD)in Sudan Heart disease is the leading cause of more bi and mortality in Sudan.Hypertension (RHD), (IHD), and cardiomyopathy account for the majority of four (CVD).Hypertension is common and poorly controlled.tobacco se , unhealthy diet and obesity, physical inactivity, hypertension, diabetes, and elevated lipids more than half of the heart deaths in 2009 were men Coronary heart disease (CHD) is the most common type of heart disease, causing more than(385,000) deaths each year.Ischemic heart disease is associated with progressive mechanical obstruction, disease [12,13].Bio mark arrasene of the tools to better identify at-risk individuals, and diagnose medical dynamic obstruction, plaque inflammation, instability, and future followed by superimposed thrombosis.Clinicians are employing additional tools to ai c clinical assessment and improve their ability to identify "at-risk" patients who are at risk for cardiovascular conditions quickly and accurately, and effectively diagnose and treat sick patients.Biomarkers can be measured in biological samples (as blood, urine, or tissue tests), can be human records (blood pressure, electrocardiogram, or holder), or imaging tests (echocardiogram).Normally, very small amounts of iron are present in most body cells, plasma, and other extracellular fluids and the body strictly limits its iron supply so that every day (0.1%)of the body's iron content is lost.maintain.Mainly in desquamated cells Iron`s high activity is a two-edged sword, and free iron ions in the body also participate in destructive chemistry

Study design
This is an analytical, laboratory-based, hospital casecontrol study to evaluate the iron profile and coagulation profile of patients with chemic heart disease at Elmer-Nimr University Hospital for the period from December 2021 to October 2021.

Study area
The study was conducted at his Elmer-Nimr University Hospital in Shendi City, Sudan Shendi is a city in northern Sudan, northeast of Khartoum, on the eastern bank of the Nile River (150 km).Shendi is also Most cardiovascular diseases can be prevented by addressing risk factors such as primarily in catalyzing the formation of toxic free radicals.Iron plays a role in the process of a or s sclerosis by catalyzing the formation of free radicals and also this contributes to reperfusion damage.High serum ferret concentration was associated with increased risk of my nocardial in fraction independent to f major cardiovascular risk factors.Abnormal deposition of iron in the heart t cause hem chromatists and dilated cardiomyopathy and this causes causing ischemic heart diseases Coagulation plays a role in is chemic heart disease, and increased plasma eve ls of coagulation protein are associated with an increased risk of my nocardial infraction The prothrombin in time alone is derived from measures of prothrombin in ratio{ PR} and international normalized ratio {INR] are assay s evaluating the extrinsic pathway and common pathway of coagulation.they are used to determine the clotting tendency of blood in the measure of war far in dosage The role of blood clotting activation such as elevated circulating level of a marker of thrombin generation and fibroin peptide Ai n the occurrence of anguinine scheme heart disease Activated thrombi past in time is used to monitor the effects of the par in on intrinsic pathways and detect defects in factors XII, XI, IX, VIII, and the common pathway.about(45km)southwest of the ancient city of Meroe Located on the Nile State River.Its main western bank suburb is Al Matata.A major traditional trade route through the Bayada Desert connects Al Madama to the northwest with Napata (250km) in Malawi.

Study population
A total of (50)samples were collected from the study group of ischemic heart patients.

Inclusion Criteria
Both men and women with ischemic heartsease (medicated or not) participated in the study

Data Collection Tools
Data were collected using a laboratory-based scored pre-coded questionnaire.Its nature is designed to ultimately retrieve useful information for research.

Ethical Considerations
The procedure for venous blood sampling was explained to the patient undergoing the examination.All participants were briefed on the purpose and procedures of the study during the interview period.Valid written consent was obtained from all participants.All results were highly private and confidential Demographically, a total of 30 blood samples were collected frompatientswithischemicheartdiseaseand20fromhea lth subjects as controls.Participation in ischemic heart disease mirrored 30(60%) and 20 (40%) of the control group (Table 1).The frequency of ischemic heart disease patients was 9 males (18%)and 21 females (42%) (Table 2).As a result of the analysis, the mean PT and PTT of the case group (13.4 seconds) (and 40.4 seconds) was), and the mean of PT and PTT of the control group was (12.0 seconds) (and procedures of the study during the interview period.Valid written consent was obtained from all participants.All results were highly private and confidential 35.1seconds) (Table 3).The analysis also shows the average iron, TIBC, and ferritin values (41.0 ng/dl) in this case.(44.0), (233.0), and mean iron and TI BC and ferritin in controls (27.0 ng/dl), (56.0), (162, 0) (Table 4).The male and female averages in PT were (13.3),(13.5)seconds and the male and female averages in PTT were (43.6)(39.0)seconds (Table 5).Also, the mean of S .iron,TIBC, S. Ferritin in men (38.0), (45.0), (255.0) and the mean of S .iron,TIBC, S. Ferritin in women (42,2), (56.0), (224.2) (Table6).[16].Furthermore, the results showed that the average PT was in males (13.3 s) and females (13.5 s).On the other hand, the results show the average PTT values for men (43.6 seconds)and women (39.0 seconds), with no significant difference between men and women.The results of this study showed significant statistical differences between PT and PTT compared by gender.Further results were iron and TIBC in men (38.0), (45.5) and women (42.2), (56.0).These results indicated no significant difference between males and females (P.value0.456).On the other hand, the average value of S. ferritin was (255.0) in men and (244.2) in women.These results showed a significant difference between men and women (P.value0.000),this study disagreed with that reported by Wafaa Bashir and her colleague, 2022 showed that the mean of S. ferritin in males was (206.3μg/dl) and in females was (162.2μg/dl) which showed an insignificant statically value, (P.value 0.101) [17].

Conclusion
PT and PTT were increased in subjects with ischemic heart disease compared to control subjects.S. iron and S. ferritin were increased in ischemic heart disease patients compared to healthy controls.TIBC was lower in the ischemic heart disease patient compared to healthy subjects in the control group.PT and PTT increase according to gender.S. iron, TIBC, s.Ferritin increased according to gender.

Table - 4
: The comparison between iron and TIBC and Ferritin in case and control.

Table - 5
: comparison between PT and PTT in male and female.

Table - 6
: The comparison between iron and TIBC and Ferritin in male and female cardiolipin fraction.As a result, the average S.The iron content of the case (41.0 μ g/dl) and the control (27.0 μ g/dl) showed a significant difference (P.value 0.010).The results also show that the mean of TIBC