Premium
Serum ferritin and risk for new‐onset heart failure and cardiovascular events in the community
Author(s) -
Klip IJsbrand T.,
Voors Adriaan A.,
Swinkels Dorine W.,
Bakker Stephan J.L.,
KootstraRos Jenny E.,
Lam Carolyn S.,
van der Harst Pim,
van Veldhuisen Dirk J.,
van der Meer Peter
Publication year - 2017
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.622
Subject(s) - hepcidin , medicine , interquartile range , ferritin , heart failure , prospective cohort study , population , cohort , incidence (geometry) , physiology , cardiology , gastroenterology , endocrinology , anemia , physics , environmental health , optics
Aims Heart failure ( HF ) is a common manifestation of patients with primary and secondary causes of iron overload, whereas in patients with established HF iron deficiency impairs outcome. Whether iron stores, either depleted or in overload, amplify the risk for new‐onset HF among healthy individuals is unknown. The present study aimed to assess whether markers of iron status or the iron‐regulatory hormone hepcidin are associated with new‐onset HF or cardiovascular ( CV ) events in the general population. Methods and results In 6386 subjects from the Prevention of REnal and Vascular ENd ‐stage Disease ( PREVEND ) trial, a prospective, community‐based, cohort study, markers of iron status and the iron‐regulatory hormone hepcidin were measured. Mean age was 53.1 ± 12.0 years, and 50.7% of the cohort was female. During a median follow‐up of 8.3 (interquartile range 7.8–8.9) years, 199 subjects (3.1%) were newly diagnosed with HF , 456 (7.1%) experienced a CV event, and 356 (5.6%) died from all causes. A higher annual HF incidence per ferritin quartile was observed in women ( P < 0.001), but not in men ( P for interaction 0.032). Multivariable analyses demonstrated ferritin levels to remain independently predictive for new‐onset HF in women only ( P = 0.024). This association persisted within strata defined by markers of the metabolic syndrome, markers of inflammation, or other markers of iron homeostasis, including hepcidin. No association between ferritin or hepcidin and incident CV events or all‐cause mortality was observed in either sex. Conclusions Increased serum ferritin levels independently amplify the risk for new‐onset HF in women in the community.