Iron status and its association with coronary heart disease: Systematic review and meta-analysis of prospective studies

De, Sudeep Das; Krishna, Sreedhar; Jethwa, Ankeet

doi:10.1016/j.atherosclerosis.2014.12.018

Cited by 71 publications

(48 citation statements)

References 38 publications

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“…30 However, contrary to Sullivan's hypothesis, a significant negative association was identified between transferrin saturation and CAD or MI, leading to the conclusion that high body iron stores could confer protection against development of CHD. 30,31 In contrast to the proposal that iron depletion via blood loss has potential benefit, in a study involving 38,244 men free from diagnosed cardiovascular disease, blood donations were not associated with the risks of MI or fatal CHD. 32 During 4 years of follow-up observation, 328 nonfatal MIs and 131 coronary deaths occurred.…”

Section: Iron In Cadmentioning

confidence: 87%

“…29 Subsequent meta-analyses have also found no positive association between body iron content and CAD. 30,31 In a systematic review and meta-analysis of 21 studies, including 9,236 patients with CAD or myocardial infarction (MI) and a total of 156,427 participants, with follow-up duration of 3-17 years, no significant association was found between serum ferritin, total iron-binding capacity, serum iron, and CAD or MI. 30 However, contrary to Sullivan's hypothesis, a significant negative association was identified between transferrin saturation and CAD or MI, leading to the conclusion that high body iron stores could confer protection against development of CHD.…”

Section: Iron In Cadmentioning

confidence: 99%

“…30,31 In a systematic review and meta-analysis of 21 studies, including 9,236 patients with CAD or myocardial infarction (MI) and a total of 156,427 participants, with follow-up duration of 3-17 years, no significant association was found between serum ferritin, total iron-binding capacity, serum iron, and CAD or MI. 30 However, contrary to Sullivan's hypothesis, a significant negative association was identified between transferrin saturation and CAD or MI, leading to the conclusion that high body iron stores could confer protection against development of CHD. 30,31 In contrast to the proposal that iron depletion via blood loss has potential benefit, in a study involving 38,244 men free from diagnosed cardiovascular disease, blood donations were not associated with the risks of MI or fatal CHD.…”

Section: Iron In Cadmentioning

confidence: 99%

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Iron deficiency and cardiovascular disease

Haehling

Jankowska

Veldhuisen³

et al. 2015

Nat Rev Cardiol

241

151

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Iron deficiency affects up to one-third of the world's population, and is particularly common in elderly individuals and those with certain chronic diseases. Iron excess can be detrimental in cardiovascular illness, and research has now also brought anaemia and iron deficiency into the focus of cardiovascular medicine. Data indicate that iron deficiency has detrimental effects in patients with coronary artery disease, heart failure (HF), and pulmonary hypertension, and possibly in patients undergoing cardiac surgery. Around one-third of all patients with HF, and more than one-half of patients with pulmonary hypertension, are affected by iron deficiency. Patients with HF and iron deficiency have shown symptomatic improvements from intravenous iron administration, and some evidence suggests that these improvements occur irrespective of the presence of anaemia. Improved exercise capacity has been demonstrated after iron administration in patients with pulmonary hypertension. However, to avoid iron overload and T-cell activation, it seems that recipients of cardiac transplantations should not be treated with intravenous iron preparations.

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Section: Iron In Cadmentioning

confidence: 87%

Section: Iron In Cadmentioning

confidence: 99%

Section: Iron In Cadmentioning

confidence: 99%

See 1 more Smart Citation

Iron deficiency and cardiovascular disease

Haehling

Jankowska

Veldhuisen³

et al. 2015

Nat Rev Cardiol

241

151

View full text Add to dashboard Cite

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“…Markers of iron deficiency have been related to an increased incidence of cardiovascular disease, mainly myocardial infarction, CHD, and cardiovascular death, and worse outcomes in patients with HF . However, to the best of our knowledge, the association with incident HF has never been tested.…”

Section: Discussionmentioning

confidence: 99%

“…Disorders of iron metabolism, either deficiency or overload, have been associated with increased cardiovascular morbidity and mortality . Severe iron overload, owing to acquired and genetic haemochromatosis, has been consistently associated with cardiomyopathy and a higher incidence of heart failure (HF) .…”

Section: Introductionmentioning

confidence: 99%

Ferritin levels and risk of heart failure—the Atherosclerosis Risk in Communities Study

Silvestre

Gonçalves

Nadruz

et al. 2016

European J of Heart Fail

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Aims Severe iron overload is associated with cardiac damage, while iron deficiency has been related to worse outcomes in subjects with heart failure (HF). This study investigated the relationship between ferritin, a marker of iron status, and the incidence of HF in a community-based cohort. Methods and results We examined 1,063 participants who were free of heart failure from the Atherosclerosis Risk in Communities (ARIC) study in whom ferritin serum levels were measured at baseline (1987–1989). The participants (mean age 52.7 ± 5.5 years, 62% women), were categorized in low (<30 ng/mL; n=153), normal (30–200 ng/mL in women and 30–300 ng/mL in men; n=663) and high (>200 ng/mL in women and >300 ng/mL in men; n=247) ferritin levels. Multivariable Cox proportional hazards models were used to evaluate the relationship between ferritin and incident HF. After 20.9±4.6 years of follow-up, HF occurred in 144 (13.5%) participants. When compared to participants with normal ferritin levels, participants with low ferritin levels had a higher risk of HF (HR= 2.24, 95% CI= 1.15–4.35; p=0.02) as did those with high ferritin levels (HR=1.81, 95% CI=1.01–3.25; p=0.04), after adjusting for potential confounders. Notably, low ferritin levels remained associated with incident HF even after excluding subjects with anemia (HR= 2.28, 95% CI= 1.11–4.68; p= 0.03). Conclusion Derangements in iron metabolism, either low or high ferritin serum levels, were associated with higher risk of incident HF in a general population, even without concurrent anemia. These findings suggest that iron imbalance might play a role in the development of HF.

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Predictive value of serum iron on heart failure in patients with acute ST‐segment elevation myocardial infarction

Chen

Lin

Dai

et al. 2023

Clinical Cardiology

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Background: In clinical practice, heart failure often occurs after acute myocardial infarction, and a new biomarker for its early prediction is urgently needed. The aim of this study was to investigate the relationship between serum iron and heart failure after acute ST-segment elevation myocardial infarction (STEMI).Methods: A total of 41 patients with heart failure after STEMI and 31 controls were included in the study. The demographic variables and baseline clinical characteristics of both groups were analyzed.Results: There were no significant differences between patients with heart failure and controls in terms of demographic characteristics. There were significant differences in terms of serum iron, N terminal pro-B-type natriuretic peptide levels, left atrial diameter, and left ventricular ejection fraction. Binary logistic regression analyses demonstrated that serum iron (odds ratio [OR]: 0.804, 95% confidence interval [CI]: 0.699-0.924) and Tn-I (OR: 1.072, 95% CI: 1.011-1.137) were independent predictors for heart failure (p < .05, respectively). Receiver operating characteristic analysis showed that the area under the curve for serum iron was 0.808 (95% CI: 0.707-0.908, p < .01). The best cutoff value of serum iron was 11.87 μmol/L (sensitivity: 87.1%; specificity: 68.3%).Conclusions: Patients with heart failure after STEMI have lower serum iron levels than patients without heart failure after STEMI. Serum iron levels are a risk factor for heart failure after STEMI.

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Iron status and its association with coronary heart disease: Systematic review and meta-analysis of prospective studies

Cited by 71 publications

References 38 publications

Iron deficiency and cardiovascular disease

Iron deficiency and cardiovascular disease

Ferritin levels and risk of heart failure—the Atherosclerosis Risk in Communities Study

Predictive value of serum iron on heart failure in patients with acute ST‐segment elevation myocardial infarction

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