Iron Deficiency in Adolescent and Young Adult German Athletes-A Retrospective Study.

Background: Iron deficiency is a common phenomenon in sports and may lead to impaired physical performance. The aim of the study was to determine the frequency of iron deficiency in competitive athletes and to discuss the resulting consequences. Methods: The data of 629 athletes (339 male, 290 female) who presented for their annual basic sports medicine examination were investigated. Depending on age (<14 years, 15−17 years, ≥18−30 years), four groups ((I.) normal hemoglobin (Hb) and ferritin level (≥30 ng/mL for adults and 15−18-year-olds; ≥20 ng/mL, respectively, ≥15 ng/mL for adolescents and children), (II.) prelatent iron deficiency (ID) (normal Hb, low ferritin), (III.) latent ID (additionally elevated soluble transferrin receptor or decreased transferrin saturation) and (IV.) manifest anemia) were distinguished. In addition, the iron status and exercise capacity of different types of sports were compared. Results: Overall we found an iron deficiency of 10.9% in male (mainly in adolescence) and 35.9% in female athletes (emphasized in adolescence and young adulthood). There were no significant differences in iron status in regard to the different sport types or in maximum performance for the different groups of iron deficiency. Conclusions: Adolescent and female athletes are more likely to have an iron deficiency. Therapy concepts for athletes therefore should pay attention to iron-rich diets.

Effect of Ranolazine on Ischemic Myocardium IN Patients With Acute Cardiac Ischemia (RIMINI-Trial): A Randomized Controlled Pilot Trial.

BACKGROUND: Coronary artery disease is the most prevalent manifestation among cardiovascular diseases. Despite modern treatment, risk of ischemic complications in patients with acute coronary syndrome (ACS) remains important. The late Na+ current blocker ranolazine has shown to reduce the risk of recurrent ischemia and worsening of angina in patients with non-ST-segment elevation ACS by possibly improving myocardial perfusion, but up to now no trial has addressed whether this enhanced perfusion also leads to a decrease in ischemic myocardium of patients with ACS. We designed a pilot trial (Reduction of Ischemic Myocardium with Ranolazine-Treatment IN patients with acute myocardial Infarction, ClinicalTrials.gov Identifier: NCT01797484) for feasibility and proof of concept that a 6-week ranolazine add-on therapy would reduce the area of ischemic myocardium in patients with ACS. METHODS AND RESULTS: The trial was designed in a 2-armed, controlled and randomized way. Twenty participants with unstable angina, proof of acute cardiac ischemia, and myocardial dyskinesia by speckle-tracking echocardiography were included. Ten participants received the study drug ranolazine additionally to standard treatment. The control group received standard treatment without additional study medication. Speckle-tracking echocardiography was performed before coronary intervention, before the first dose of ranolazine, and after 6 weeks of ranolazine treatment. Ranolazine was administered safely during acute myocardial infarction. Speckle-tracking echocardiography proved to be suitable for evaluation of myocardial dyskinesia. Patients receiving ranolazine showed a trend to higher normal fraction of the cumulative global strain than patients in the standard treatment group (15% vs 11%). No major complications relating study medication were observed. CONCLUSION: In conclusion, in this preliminary hypothesis-driven study, 6-week ranolazine therapy was shown to decrease the area of dyskinetic myocardium in patients with ACS by trend. Global strain rate measurement using speckle-tracking echocardiography can be applied measuring those effects and is, compared to other techniques, safe and harmless. Our data provide a sound basis for a follow-up trial.