Iron status and clinical outcome in patients with coronary artery disease after coronary stenting.
OBJECTIVE
So far, no studies have assessed whether there is an association between iron status and the incidence of major adverse cardiac events or restenosis after coronary stenting. We conducted this study to investigate whether there is an association between body iron status and clinical outcome in patients with coronary artery disease after coronary stenting.


RESULTS
The study included 664 patients with coronary artery disease who underwent coronary stent implantation. The soluble transferring receptor/ferritin ratio (sTfR/ferritin ratio) was used as an index of iron status. Patients were divided into three groups according to the tertiles of sTfR/ferritin ratio: lower tertile (<11.9; n = 221), middle tertile (11.9-27.8; n = 221) and upper tertile (>27.8; n = 222). The combined incidence of major adverse cardiac events (death, myocardial infarction and target vessel revascularization) was the primary end point of the study. Patients in the lower tertile of the sTfR/ferritin ratio presented more often with unstable angina or acute myocardial infarction and had longer lesions and higher grade of stenosis than the patients in the middle or upper tertile of the sTfR/ferritin ratio. Angiographic restenosis at 6-month angiography was also evaluated. The cumulative event rate of composite end point of death, myocardial infarction or target vessel revascularization was 27.6% in patients in the lower tertile, 24.4% in patients in the middle tertile and 28.4% in patients in the upper tertile of the sTfR/ferritin ratio (p = 0.68). Restenosis was found in 27.8% (n = 45) in the lower tertile, 25.8% (n = 42) in the middle tertile and 27.5% (n = 38) in the upper tertile of the sTfR/ferritin ratio (p = 0.90).


CONCLUSIONS
Our study showed no association between iron status and the incidence of major adverse cardiac events or angiographic coronary restenosis in patients with coronary artery disease after coronary stenting.
Ndrepepa
Gjin
G
Klinik für Herz- und Kreislauferkrankungen und Institut für Laboratoriumsmedizin, Deutsches Herzzentrum München and Technische Universität München, Lazarettstrasse 36, 80636 München, Germany. ndrepepa@dhm.mhn.de
Braun
Siegmund
S
Dibra
Alban
A
Mehilli
Julinda
J
Vogt
Wolfgang
W
Schömig
Albert
A
Kastrati
Adnan
A
D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000453:epidemiology*; D011990:Receptors, Transferrin / Q000378:metabolism*; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome
D011990:Receptors, Transferrin; D005293:Ferritins; D007501:Iron