Iron status and survival in diabetic patients with coronary artery disease
Beata Ponikowska , Tomasz Suchocki , B. Paleczny , Martyna Olesińska , Sławomir Powierza , Ludmiła Borodulin-Nadzieja , Krzysztof Reczuch , Stephan von Haehling , Wolfram Doehner , Stefan D. Anker , John G F Cleland , Ewa Anita Jankowska
AbstractObjective-To investigate the impact of iron status on survival in patients with type 2 diabetes and coronary artery disease (CAD). Research Design and Methods-Serum ferritin, transferrin saturation (Tsat), and soluble transferrin receptor (sTfR) were measured in 287 patients with type 2 diabetes and stable CAD (65 ± 9 years of age, 78% men). Results-During a mean follow-up of 45 ± 19 months, there were 59 (21%) deaths and 60 (21%) cardiovascular hospitalizations. Both serum ferritin and sTfR strongly predicted 5-year all-cause mortality rates, independently of other variables (including hemoglobin, measures of renal function, inflammation, and neurohormonal activation). There was an exponential relationship between sTfR and mortality (adjusted hazard ratio [HR] per 1 log mg/L · 4.24 [95% CI 1.43-12.58], P = 0.01), whereas the relationship between ferritin and mortality was U-shaped (for the lowest and the highest quintiles vs. the middle quintile [reference group], respectively: adjusted HR 7.18 [95% CI 2.03-25.46], P = 0.002, and adjusted HR 5.12 [1.48-17.73], P = 0.01). Similar patterns were observed for the composite outcome of all-cause mortality or cardiovascular hospitalization, and in these multivariable models, low Tsat was related to unfavorable outcome. Conclusions-Both low and high serum ferritin (possibly reflecting depleted and excessive iron stores, respectively) along with high serum sTfR (reflecting reduced metabolically available iron) identify patients with type 2 diabetes and CAD who have a poor prognosis. © 2013 by the American Diabetes Association.
|Journal series||Diabetes Care, ISSN 0149-5992, (A 45 pkt)|
|Publication size in sheets||0.5|
|ASJC Classification||; ;|
|Score|| = 45.0, 12-05-2020, ArticleFromJournal|
= 45.0, 12-05-2020, ArticleFromJournal
|Publication indicators||= 27; = 26; : 2013 = 3.605; : 2013 = 8.57 (2) - 2013=8.462 (5)|
|Citation count*||45 (2020-09-24)|
* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.