title: Hemoglobin, iron metabolism and angiographic coronary artery disease (The Ludwigshafen Risk and Cardiovascular Health Study).
abstract: BACKGROUND
  Anemia has been shown to be a risk factor for coronary artery disease and mortality. The involvement of body iron stores in the development of CAD remains controversial. So far, studies that examined hemoglobin and parameters of iron metabolism simultaneously do not exist.
  
  
  RESULTS
  Hemoglobin and iron status were determined in 1480 patients with stable angiographic coronary artery disease (CAD) and in 682 individuals in whom CAD had been ruled out by angiography. The multivariate adjusted odds ratios (OR) for CAD in the lowest quartiles of hemoglobin and iron were 1.62 (95%CI: 1.22-2.16), and 2.05 (95%CI: 1.51-2.78), respectively compared to their highest gender-specific quartiles. The fully adjusted ORs for CAD in the lowest quartiles of transferrin saturation, ferritin (F) and soluble transferrin receptor (sTfR)/log10F index were 1.69 (95%CI: 1.25-2.27), 1.98 (95%CI: 1.48-2.65), and 1.64 (95%CI: 1.23-2.18), respectively compared to their highest gender-specific quartiles. When adjusting in addition for iron and ferritin the OR for CAD in the lowest quartiles of hemoglobin was still 1.40 (95%CI: 1.04-1.90) compared to the highest gender-specific quartiles. Thus, the associations between either iron status or low hemoglobin and CAD appeared independent from each other. The sTfR was only marginally associated with angiographic CAD.
  
  
  CONCLUSIONS
  Both low hemoglobin and iron depletion are independently associated with angiographic CAD.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany; Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany. Electronic address: Tanja.Grammer@medma.uni-heidelberg.de.
authors.forename: Tanja B
authors.initials: TB
authors.lastname: Grammer
authors.affiliation: Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany.
authors.forename: Marcus E
authors.initials: ME
authors.lastname: Kleber
authors.affiliation: Department of Angiology, Swiss Cardiovascular Center, Inselspital, University of Bern, Switzerland.
authors.forename: Günther
authors.initials: G
authors.lastname: Silbernagel
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors.forename: Hubert
authors.initials: H
authors.lastname: Scharnagl
authors.affiliation: Specialist Clinic for Rehabilitation PVA Bad Aussee, Bad Aussee, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Tomaschitz
authors.affiliation: Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: König
authors.affiliation: Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetolgy, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Synlab Academy, Synlab Services GmbH, Mannheim, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: März
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood; D005858:Germany / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011990:Receptors, Transferrin / Q000097:blood; D012907:Smoking / Q000453:epidemiology; D014168:Transferrin / Q000032:analysis
chemical_list: D006454:Hemoglobins; C508600:IL6 protein, human; D015850:Interleukin-6; D011990:Receptors, Transferrin; D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: Coronary artery disease; Ferritin; Hemoglobin; Iron; Soluble transferrin receptor; Transferrin saturation