Association of iron deficiency with incident cardiovascular diseases and mortality in the general population
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Association of iron deficiency with incident cardiovascular diseases and mortality in the general population. / Schrage, Benedikt; Rübsamen, Nicole; Ojeda, Francisco M; Thorand, Barbara; Peters, Annette; Koenig, Wolfgang; Söderberg, Stefan; Söderberg, Maja; Mathiesen, Ellisiv B; Njølstad, Inger; Kee, Frank; Linneberg, Allan; Kuulasmaa, Kari; Tarja, Palosaari; Salomaa, Veikko; Blankenberg, Stefan; Zeller, Tanja; Karakas, Mahir.
in: ESC HEART FAIL, Jahrgang 8, Nr. 6, 12.2021, S. 4584-4592.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Association of iron deficiency with incident cardiovascular diseases and mortality in the general population
AU - Schrage, Benedikt
AU - Rübsamen, Nicole
AU - Ojeda, Francisco M
AU - Thorand, Barbara
AU - Peters, Annette
AU - Koenig, Wolfgang
AU - Söderberg, Stefan
AU - Söderberg, Maja
AU - Mathiesen, Ellisiv B
AU - Njølstad, Inger
AU - Kee, Frank
AU - Linneberg, Allan
AU - Kuulasmaa, Kari
AU - Tarja, Palosaari
AU - Salomaa, Veikko
AU - Blankenberg, Stefan
AU - Zeller, Tanja
AU - Karakas, Mahir
N1 - © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2021/12
Y1 - 2021/12
N2 - AIMS: Although absolute (AID) and functional iron deficiency (FID) are known risk factors for patients with cardiovascular (CV) disease, their relevance for the general population is unknown. The aim was to assess the association between AID/FID with incident CV disease and mortality in the general population.METHODS AND RESULTS: In 12 164 individuals from three European population-based cohorts, AID was defined as ferritin < 100 μg/L or as ferritin < 30 μg/L (severe AID), and FID was defined as ferritin < 100 μg/L or ferritin 100-299 μg/L and transferrin saturation < 20%. The association between iron deficiency and incident coronary heart disease (CHD), CV mortality, and all-cause mortality was evaluated by Cox regression models. Population attributable fraction (PAF) was estimated. Median age was 59 (45-68) years; 45.2% were male. AID, severe AID, and FID were prevalent in 60.0%, 16.4%, and 64.3% of individuals. AID was associated with CHD [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.04-1.39, P = 0.01], but not with mortality. Severe AID was associated with all-cause mortality (HR 1.28, 95% CI 1.12-1.46, P < 0.01), but not with CV mortality/CHD. FID was associated with CHD (HR 1.24, 95% CI 1.07-1.43, P < 0.01), CV mortality (HR 1.26, 95% CI 1.03-1.54, P = 0.03), and all-cause mortality (HR 1.12, 95% CI 1.01-1.24, P = 0.03). Overall, 5.4% of all deaths, 11.7% of all CV deaths, and 10.7% of CHD were attributable to FID.CONCLUSIONS: In the general population, FID was highly prevalent, was associated with incident CHD, CV death, and all-cause death, and had the highest PAF for these events, whereas AID was only associated with CHD and severe AID only with all-cause mortality. This indicates that FID is a relevant risk factor for CV diseases in the general population.
AB - AIMS: Although absolute (AID) and functional iron deficiency (FID) are known risk factors for patients with cardiovascular (CV) disease, their relevance for the general population is unknown. The aim was to assess the association between AID/FID with incident CV disease and mortality in the general population.METHODS AND RESULTS: In 12 164 individuals from three European population-based cohorts, AID was defined as ferritin < 100 μg/L or as ferritin < 30 μg/L (severe AID), and FID was defined as ferritin < 100 μg/L or ferritin 100-299 μg/L and transferrin saturation < 20%. The association between iron deficiency and incident coronary heart disease (CHD), CV mortality, and all-cause mortality was evaluated by Cox regression models. Population attributable fraction (PAF) was estimated. Median age was 59 (45-68) years; 45.2% were male. AID, severe AID, and FID were prevalent in 60.0%, 16.4%, and 64.3% of individuals. AID was associated with CHD [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.04-1.39, P = 0.01], but not with mortality. Severe AID was associated with all-cause mortality (HR 1.28, 95% CI 1.12-1.46, P < 0.01), but not with CV mortality/CHD. FID was associated with CHD (HR 1.24, 95% CI 1.07-1.43, P < 0.01), CV mortality (HR 1.26, 95% CI 1.03-1.54, P = 0.03), and all-cause mortality (HR 1.12, 95% CI 1.01-1.24, P = 0.03). Overall, 5.4% of all deaths, 11.7% of all CV deaths, and 10.7% of CHD were attributable to FID.CONCLUSIONS: In the general population, FID was highly prevalent, was associated with incident CHD, CV death, and all-cause death, and had the highest PAF for these events, whereas AID was only associated with CHD and severe AID only with all-cause mortality. This indicates that FID is a relevant risk factor for CV diseases in the general population.
U2 - 10.1002/ehf2.13589
DO - 10.1002/ehf2.13589
M3 - SCORING: Journal article
C2 - 34610649
VL - 8
SP - 4584
EP - 4592
JO - ESC HEART FAIL
JF - ESC HEART FAIL
SN - 2055-5822
IS - 6
ER -