Functional iron deficiency associated with incident CHD and mortality in the general population
Association of iron deficiency with incident cardiovascular diseases and mortality in the general population
Functional iron deficiency is a relevant risk factor for CVD and mortality in the general population according to the authors of a study that investigated the relationship between iron deficiency and incident CVD and mortality.
Introduction and methods
Multiple studies have suggested that both absolute (AID) and functional iron deficiency (FID) are associated with morbidity and mortality in patients with CVD [1-4]. However, whether AID and FID are associated with incident coronary heart disease (CHD) in the general population remains uncertain.
Aim of the study
This study used data from three European cohort studies to investigate the association between AID, severe AID and FID with incident CHD and mortality in the general population.
The analysis included 12,164 individuals. Median age was 59 years and 45.2% were male. AID was defined as ferritin <100 µg/L, severe AID as ferritin <30 µg/L and FID as ferritin <100 µg/L or ferritin 100-299 µg/L and TSAT <20%.
Investigated outcomes were incident CHD, CV mortality, all-cause mortality and incident stroke. Median follow-up was 13.3 years.
- Among the 12,164 individuals, 60% had AID, 16.4% had severe AID and 64.3% had FID.
- AID was associated with incident CHD (HR 1.22, 95%CI 1.04-1.39, P=0.01) in the general population after adjustment for multiple confounders, but not with all-cause mortality, CV mortality or incident stroke.
- Severe AID was associated with all-cause mortality (HR 1.28, 95% CI 1.12-1.46, P<0.01), but not with incident CHD, CV mortality or incident stroke.
- FID was independently associated with all-cause mortality (HR 1.12, 95% CI 1.01-1.24, P=0.03), CV mortality (HR 1.26, 95% CI 1.03-1.54, P=0.03) and with incident CHD (HR 1.24, 95% CI 1.07-1.43, P<0.01), but not with incident stroke.
- Within 10 years of follow-up, 10.7% of CHD incidence, 5.4% of all deaths and 11.9% of all CV deaths were attributable to FID (population attributable fraction).
FID was highly prevalent in the European population-based cohorts and associated with incident CHD, all-cause mortality and CV mortality after adjustment for multiple confounders. AID was only associated with incident CHD and severe AID only with all-cause mortality.
The authors of this article state: “these results underline the importance of TSAT measurement for diagnosis of ID and highlight FID as a relevant risk factor for CVD and mortality in the general population.”