The iron (Fe) and atherosclerosis study (FeAST): a pilot study of reduction of body iron stores in atherosclerotic peripheral vascular disease.
BACKGROUND
Levels of body iron stores, represented by the serum ferritin concentration, rise with age after adolescence in men and menopause in women. This rise has been implicated mechanistically and epidemiologically in the pathogenesis of atherosclerosis through iron-induced oxygen free radical-mediated lipid oxidation. However, the precise contribution of iron stores to atherosclerosis and its complications are unknown because prospective randomized trials designed to test effects of reduction of iron stores on clinical outcomes in this disease have not been performed.


RESULTS
In preparation for a prospective randomized trial, a randomized pilot study was conducted to evaluate the feasibility, safety, and methodologic accuracy of calibrated reduction in iron stores by phlebotomy in a cohort of patients with advanced peripheral vascular disease. Phlebotomy resulted in a significant reduction in serum ferritin concentration to near targeted levels. Thus the formula for calculating the volume of blood to be removed to achieve a predetermined decrement in serum ferritin concentration was accurate and phlebotomy was not associated with any adverse laboratory or clinical effects.


CONCLUSIONS
Reduction of body iron stores to a predetermined level is feasible and can be achieved in a timely manner with excellent patient compliance. Prospective randomized trials of calibrated reduction of body iron stores may be undertaken to define their pathophysiologic significance in atherosclerosis and other diseases in which excessive iron-induced oxidative stress has been implicated.
Zacharski
L R
LR
Department of Veterans Association Medical Centers, White River Junction, VT 05009-0001, USA. leo.r.zacharski@dartmouth.edu
Chow
B
B
Lavori
P W
PW
Howes
P S
PS
Bell
M R
MR
DiTommaso
M A
MA
Carnegie
N M
NM
Bech
F
F
Amidi
M
M
Muluk
S
S
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood / Q000378:metabolism*; D003327:Coronary Disease / Q000378:metabolism; D005240:Feasibility Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000378:metabolism*; D010865:Pilot Projects
D005293:Ferritins; D007501:Iron