Serum Ferritin-a Novel Risk Factor in Acute Myocardial Infarction

Overview

Journal Indian Heart J

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2012 May 11

PMID 22572495

Citations 17

Authors

M P Holay

A A Choudhary

S D Suryawanshi

Affiliations

Soon will be listed here.

Abstract

Background: A possible association between body iron status and risk of coronary heart disease (CHD) has been found to be controversial from the data obtained from various studies.

Objectives: To study the relationship of serum ferritin with acute myocardial infarction (AMI) in univariate and multivariate analysis and to assess the relationship of high serum ferritin with established conventional risk factors.

Methods: Hospital based case-control study of 75 cases of AMI, and 75 age and equal number of age, and gender-matched controls without having AMI in the age group of 30-70 years.

Results: Median serum ferritin levels were significantly higher in cases (220 μg/L) than controls (155 μg/L) (P ≤ 0.0001. In univariate analysis in addition to ferritin > 200 μg/L (odds ratio [OR] 6.71, 95% confidence interval [CI] = 3.22-12.89, P<0.05), diabetes (OR=7.68, 95% CI=2.95-19.13, P<0.05), hypertension (HTN) (OR=2.36, 95% CI=1.02-5.14, P<0.05) high-density lipoprotein (HDL) < 35 mg/dL (OR = 11.9, 95% CI = 2.66-52.57, P<0.05) and smoking (OR=2.17, 95% CI = 1.12-3.87, P< 0.05) were found to be significantly associated with AMI. After controlling for all conventional risk factors, in multiple logistic regression analysis, high ferritin was significantly associated with AMI. (adjusted OR=5.72, 95% CI=2.16-15.17, P < 0.001). Serum ferritin was significantly higher in diabetics than non-diabetics (P < 0.01).

Conclusion: High serum ferritin is strongly and independently associated with AMI.

Citing Articles

Effect of iron status on myocardial infarction: A two-sample Mendelian randomization study.

Xu X, Liu J, Huang Y, Han X Heliyon. 2024; 10(24):e40516.

PMID: 39720031 PMC: 11665644. DOI: 10.1016/j.heliyon.2024.e40516.

The usefulness of initial serum ferritin level as a predictor of in-hospital mortality in STEMI.

Abdelnabi M, Almaghraby A, Benjanuwattra J, Saleh Y, Ghazi R, Azeem A Br J Cardiol. 2024; 30(3):20.

PMID: 39144088 PMC: 11321463. DOI: 10.5837/bjc.2023.020.

Serum ferritin and the risk of myocardial infarction: A Mendelian randomization study.

Zhou J Medicine (Baltimore). 2024; 103(17):e37952.

PMID: 38669402 PMC: 11049730. DOI: 10.1097/MD.0000000000037952.

Iron deficiency and supplementation in heart failure.

Lakhal-Littleton S, Cleland J Nat Rev Cardiol. 2024; 21(7):463-486.

PMID: 38326440 DOI: 10.1038/s41569-024-00988-1.

Association between iron status and incident coronary artery disease: a population based-cohort study.

Guo S, Mao X, Li X, Ouyang H Sci Rep. 2022; 12(1):17490.

PMID: 36261681 PMC: 9581887. DOI: 10.1038/s41598-022-22275-0.

References

Salonen J, Nyyssonen K, Korpela H, Tuomilehto J, Seppanen R, Salonen R . High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation. 1992; 86(3):803-11. DOI: 10.1161/01.cir.86.3.803. View

Day S, Duquaine D, Mundada L, Menon R, Khan B, Rajagopalan S . Chronic iron administration increases vascular oxidative stress and accelerates arterial thrombosis. Circulation. 2003; 107(20):2601-6. DOI: 10.1161/01.CIR.0000066910.02844.D0. View

Knuiman M, Divitini M, Olynyk J, Cullen D, Bartholomew H . Serum ferritin and cardiovascular disease: a 17-year follow-up study in Busselton, Western Australia. Am J Epidemiol. 2003; 158(2):144-9. DOI: 10.1093/aje/kwg121. View

Sempos C, Looker A, Gillum R . Iron and heart disease: the epidemiologic data. Nutr Rev. 1996; 54(3):73-84. DOI: 10.1111/j.1753-4887.1996.tb03875.x. View

Kiechl S, Willeit J, Egger G, Poewe W, Oberhollenzer F . Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation. 1997; 96(10):3300-7. DOI: 10.1161/01.cir.96.10.3300. View

Aviram M . Modified forms of low density lipoprotein and atherosclerosis. Atherosclerosis. 1993; 98(1):1-9. DOI: 10.1016/0021-9150(93)90217-i. View

Esterbauer H, Gebicki J, Puhl H, Jurgens G . The role of lipid peroxidation and antioxidants in oxidative modification of LDL. Free Radic Biol Med. 1992; 13(4):341-90. DOI: 10.1016/0891-5849(92)90181-f. View

Solymoss B, Marcil M, Gilfix B, Gelinas F, Poitras A, Campeau L . The place of ferritin among risk factors associated with coronary artery disease. Coron Artery Dis. 1994; 5(3):231-5. DOI: 10.1097/00019501-199403000-00008. View

Oliver M . Antioxidant nutrients, atherosclerosis, and coronary heart disease. Br Heart J. 1995; 73(4):299-301. PMC: 483819. DOI: 10.1136/hrt.73.4.299. View

10.

Gupta R, Rastogi S, Nagar R, Kastia S, Kaul V . Dietary and serum iron, body iron stores and coronary heart disease. J Assoc Physicians India. 2001; 48(5):489-92. View

11.

Reunanen A, Takkunen H, Knekt P, Seppanen R, Aromaa A . Body iron stores, dietary iron intake and coronary heart disease mortality. J Intern Med. 1995; 238(3):223-30. DOI: 10.1111/j.1365-2796.1995.tb00926.x. View

12.

Piperno A, Trombini P, Gelosa M, Mauri V, Pecci V, Vergani A . Increased serum ferritin is common in men with essential hypertension. J Hypertens. 2002; 20(8):1513-8. DOI: 10.1097/00004872-200208000-00013. View

13.

Niederau C, Berger M, Stremmel W, Starke A, Strohmeyer G, Ebert R . Hyperinsulinaemia in non-cirrhotic haemochromatosis: impaired hepatic insulin degradation?. Diabetologia. 1984; 26(6):441-4. DOI: 10.1007/BF00262217. View

14.

Kraml P, Potockova J, Koprivova H, Stipek S, Crkovska J, Zima T . [Ferritin, oxidative stress and coronary atherosclerosis]. Vnitr Lek. 2004; 50(3):197-202. View

15.

Lapenna D, de Gioia S, Mezzetti A, Ciofani G, Consoli A, Marzio L . Cigarette smoke, ferritin, and lipid peroxidation. Am J Respir Crit Care Med. 1995; 151(2 Pt 1):431-5. DOI: 10.1164/ajrccm.151.2.7842202. View

16.

Klipstein-Grobusch K, Koster J, Grobbee D, Lindemans J, Boeing H, Hofman A . Serum ferritin and risk of myocardial infarction in the elderly: the Rotterdam Study. Am J Clin Nutr. 1999; 69(6):1231-6. DOI: 10.1093/ajcn/69.6.1231. View

17.

Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas A, Pajak A . Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation. 1994; 90(1):583-612. DOI: 10.1161/01.cir.90.1.583. View

18.

Lecube A, Hernandez C, Genesca J, Esteban J, Jardi R, Garcia L . Diabetes is the main factor accounting for the high ferritin levels detected in chronic hepatitis C virus infection. Diabetes Care. 2004; 27(11):2669-75. DOI: 10.2337/diacare.27.11.2669. View

19.

Meyers D, Strickland D, Maloley P, Seburg J, Wilson J, McManus B . Possible association of a reduction in cardiovascular events with blood donation. Heart. 1997; 78(2):188-93. PMC: 484902. DOI: 10.1136/hrt.78.2.188. View

20.

Sullivan J . Iron and the sex difference in heart disease risk. Lancet. 1981; 1(8233):1293-4. DOI: 10.1016/s0140-6736(81)92463-6. View