Association of iron deficiency with incident cardiovascular diseases and mortality in the general population

Benedikt Schrage; Nicole Rübsamen; Francisco M Ojeda; Barbara Thorand; Annette Peters; Wolfgang Koenig; Stefan Söderberg; Maja Söderberg; Ellisiv B Mathiesen; Inger Njølstad; Frank Kee; Allan Linneberg; Kari Kuulasmaa; Palosaari Tarja; Veikko Salomaa; Stefan Blankenberg; Tanja Zeller; Mahir Karakas

doi:10.1002/ehf2.13589

Association of iron deficiency with incident cardiovascular diseases and mortality in the general population

Standard

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, Vol. 8, No. 6, 12.2021, p. 4584-4592.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schrage, B, Rübsamen, N, Ojeda, FM, Thorand, B, Peters, A, Koenig, W, Söderberg, S, Söderberg, M, Mathiesen, EB, Njølstad, I, Kee, F, Linneberg, A, Kuulasmaa, K, Tarja, P, Salomaa, V, Blankenberg, S , Zeller, T & Karakas, M 2021, 'Association of iron deficiency with incident cardiovascular diseases and mortality in the general population', ESC HEART FAIL, vol. 8, no. 6, pp. 4584-4592. https://doi.org/10.1002/ehf2.13589

APA

Schrage, B., Rübsamen, N., Ojeda, F. M., Thorand, B., Peters, A., Koenig, W., Söderberg, S., Söderberg, M., Mathiesen, E. B., Njølstad, I., Kee, F., Linneberg, A., Kuulasmaa, K., Tarja, P., Salomaa, V., Blankenberg, S., Zeller, T., & Karakas, M. (2021). Association of iron deficiency with incident cardiovascular diseases and mortality in the general population. ESC HEART FAIL, 8(6), 4584-4592. https://doi.org/10.1002/ehf2.13589

Vancouver

Schrage B, Rübsamen N, Ojeda FM, Thorand B, Peters A, Koenig W et al. Association of iron deficiency with incident cardiovascular diseases and mortality in the general population. ESC HEART FAIL. 2021 Dec;8(6):4584-4592. https://doi.org/10.1002/ehf2.13589

Bibtex

@article{c96cf72ec7ee49b6a47e3f816a06b062,

title = "Association of iron deficiency with incident cardiovascular diseases and mortality in the general population",

abstract = "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.",

author = "Benedikt Schrage and Nicole R{\"u}bsamen and Ojeda, {Francisco M} and Barbara Thorand and Annette Peters and Wolfgang Koenig and Stefan S{\"o}derberg and Maja S{\"o}derberg and Mathiesen, {Ellisiv B} and Inger Nj{\o}lstad and Frank Kee and Allan Linneberg and Kari Kuulasmaa and Palosaari Tarja and Veikko Salomaa and Stefan Blankenberg and Tanja Zeller and Mahir Karakas",

note = "{\textcopyright} 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.",

year = "2021",

month = dec,

doi = "10.1002/ehf2.13589",

language = "English",

volume = "8",

pages = "4584--4592",

journal = "ESC HEART FAIL",

issn = "2055-5822",

publisher = "The Heart Failure Association of the European Society of Cardiology",

number = "6",

}

RIS

TY - JOUR

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

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 -