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Iron metabolism, hepcidin, and mortality (the Ludwigshafen Risk and Cardiovascular Health Study)

Background: Anemia has been shown to be a risk factor for coronary artery disease (CAD) and mortality, whereas the role of iron metabolism remains controversial. Methods: We analyzed iron metabolism and its associations with cardiovascular death and total mortality in patients undergoing coronary an...

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Main Authors: Grammer, Tanja B. (Author) , Scharnagl, Hubert (Author) , Dressel, Alexander (Author) , Kleber, Marcus E. (Author) , Silbernagel, Günther (Author) , Pilz, Stefan (Author) , Tomaschitz, Andreas (Author) , Koenig, Wolfgang (Author) , Mueller-Myhsok, Bertram (Author) , März, Winfried (Author) , Strnad, Pavel (Author)
Format: Article (Journal)
Language:English
Published: 2019
In: Clinical chemistry
Year: 2019, Volume: 65, Issue: 7, Pages: ?
ISSN:1530-8561
DOI:10.1373/clinchem.2018.297242
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1373/clinchem.2018.297242
Verlag, kostenfrei, Volltext: http://clinchem.aaccjnls.org/content/early/2019/03/26/clinchem.2018.297242
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Author Notes:Tanja B. Grammer, Hubert Scharnagl, Alexander Dressel, Marcus E. Kleber, Günther Silbernagel, Stefan Pilz, Andreas Tomaschitz, Wolfgang Koenig, Bertram Mueller-Myhsok, Winfried März and Pavel Strnad
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Summary:Background: Anemia has been shown to be a risk factor for coronary artery disease (CAD) and mortality, whereas the role of iron metabolism remains controversial. Methods: We analyzed iron metabolism and its associations with cardiovascular death and total mortality in patients undergoing coronary angiography with a median follow-up of 9.9 years. Hemoglobin and iron status were determined in 1480 patients with stable CAD and in 682 individuals in whom significant CAD had been excluded by angiography. Results: Multivariate-adjusted hazard ratios (HRs) for total mortality in the lowest quartiles of iron, transferrin saturation, ferritin, soluble transferrin receptor (sTfR), and hemoglobin were 1.22 (95% CI, 0.96-1.60), 1.23 (95% CI, 0.97-1.56), 1.27 (95% CI, 1.02-1.58), 1.26 (95% CI, 0.97-1.65), and 0.99 (95% CI, 0.79-1.24), respectively, compared to the second or third quartile, which served as reference because of a J-shaped association. The corresponding HRs for total mortality in the highest quartiles were 1.44 (95% CI, 1.10-1.87), 1.37 (95% CI, 1.05-1.77), 1.17 (95% CI, 0.92-1.50), 1.76 (95% CI, 1.39-2.22), and 0.83 (95% CI, 0.63-1.09) compared to the second quartile. HRs for cardiovascular death were similar. For hepcidin, the adjusted HRs for total mortality and cardiovascular deaths were 0.62 (95% CI, 0.49-0.78) and 0.70 (95% CI, 0.52-0.90) in the highest quartile compared to the lowest one. Conclusions: In stable patients undergoing angiography, serum iron, transferrin saturation, sTfR, and ferritin had J-shaped associations and hemoglobin only a marginal association with cardiovascular and total mortality. Hepcidin was continuously and inversely related to mortality.
Item Description:Gesehen am 29.08.2019
published March 27, 2019
Physical Description:Online Resource
ISSN:1530-8561
DOI:10.1373/clinchem.2018.297242

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