title: Bone marrow iron depletion is common in patients with coronary artery disease.
abstract: OBJECTIVE
  Iron deficiency (ID) may be an important, treatable co-morbidity complicating cardiovascular diseases, but considerable uncertainty exists about the diagnostic accuracy of blood tests. Accordingly, we investigated the relationship between blood tests for ID and iron stores in bone marrow aspirates, the diagnostic gold-standard for ID, in patients with stable coronary artery disease (CAD).
  
  
  METHODS
  Bone marrow aspirates were obtained from 65 patients with stable CAD undergoing cardiac surgery and 10 healthy controls. ID was defined as depleted extracellular iron stores (0-1 grade according to Gale scale) accompanied by ≤10% of erythroblasts containing iron.
  
  
  RESULTS
  Bone marrow ID was found in 31 (48%) patients with CAD but in none of the controls (p<0.01). Amongst patients with CAD, ID was present in 10 of 16 (63%) with and 21 of 49 (43%) without anaemia (p=0.17). The clinical profiles of patients with and without ID were similar. Of circulating biomarkers of ID, serum soluble transferrin receptor had the strongest association with bone marrow ID (area under curve: 0.876±0.048, 95% confidence interval: 0.762-0.948, for cut-off of ≥1.32mg/L-sensitivity: 67%, specificity: 97%).
  
  
  CONCLUSIONS
  Almost half of patients with stable CAD have profound bone marrow iron depletion that can be accurately assessed non-invasively using serum soluble transferrin receptor.
authors: Laboratory for Applied Research on Cardiovascular System, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Centre for Heart Diseases, Military Hospital, Wroclaw, Poland. Electronic address: ewa.jankowska@umed.wroc.pl.
authors: Ewa A
authors: EA
authors: Jankowska
authors: Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors: Katarzyna
authors: K
authors: Wojtas
authors: Laboratory of Molecular and Cellular Immunology, Department of Tumour Immunology, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland.
authors: Monika
authors: M
authors: Kasztura
authors: Department of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland.
authors: Grzegorz
authors: G
authors: Mazur
authors: Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland; Department of Physiology, Wroclaw Medical University, Wroclaw, Poland.
authors: Aleksandra
authors: A
authors: Butrym
authors: Centre for Heart Diseases, Military Hospital, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors: Elzbieta
authors: E
authors: Kalicinska
authors: Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors: Ilona
authors: I
authors: Rybinska
authors: Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors: Jacek
authors: J
authors: Skiba
authors: Division of Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany.
authors: Stephan
authors: S
authors: von Haehling
authors: Division of Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany; Centre for Stroke Research Berlin, Charité Medical School, Berlin, Germany.
authors: Wolfram
authors: W
authors: Doehner
authors: Division of Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany; Department of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany.
authors: Stefan D
authors: SD
authors: Anker
authors: Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
authors: Waldemar
authors: W
authors: Banasiak
authors: National Heart & Lung Institute, Imperial College, London, United Kingdom.
authors: John G F
authors: JG
authors: Cleland
authors: Centre for Heart Diseases, Military Hospital, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors: Piotr
authors: P
authors: Ponikowski
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D001853:Bone Marrow / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D007501:Iron
keywords: Bone marrow; Coronary artery disease; Iron deficiency; Soluble transferrin receptor