학술논문
Plasma Ferritin Levels, Incident Heart Failure, and Cardiac Structure and Function: The ARIC Study.
Document Type
Academic Journal
Author
Aboelsaad IAF; Brigham and Women's Hospital, Boston, Massachusetts, USA.; Claggett BL; Brigham and Women's Hospital, Boston, Massachusetts, USA.; Arthur V; Brigham and Women's Hospital, Boston, Massachusetts, USA.; Dorbala P; Brigham and Women's Hospital, Boston, Massachusetts, USA.; Matsushita K; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Lennep BW; University of Mississippi, Jackson, Mississippi, USA.; Yu B; University of Texas, Houston, Texas, USA.; Lutsey PL; University of Minnesota, Minneapolis, Minnesota, USA.; Ndumele CE; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Farag YMK; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Shah AM; Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.; Buckley LF; Brigham and Women's Hospital, Boston, Massachusetts, USA. Electronic address: lfbuckley@bwh.harvard.edu.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 101598241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-1787 (Electronic) Linking ISSN: 22131779 NLM ISO Abbreviation: JACC Heart Fail Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Whether iron deficiency contributes to incident heart failure (HF) and cardiac dysfunction has important implications given the prevalence of iron deficiency and the availability of several therapeutics for iron repletion.
Objectives: The aim of this study was to estimate the associations of plasma ferritin level with incident HF overall, HF phenotypes, and cardiac structure and function measures in older adults.
Methods: Participants in the ongoing, longitudinal ARIC (Atherosclerosis Risk In Communities) study who were free of prevalent HF and anemia were studied. The associations of plasma ferritin levels with incident HF overall and heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) were estimated using Cox proportional hazards regression models. Linear regression models estimated the cross-sectional associations of plasma ferritin with echocardiographic measures of cardiac structure and function.
Results: The cohort included 3,472 individuals with a mean age of 75 ± 5 years (56% women, 14% Black individuals). In fully adjusted models, lower ferritin was associated with higher risk for incident HF overall (HR: 1.20 [95% CI: 1.08-1.34] per 50% lower ferritin level) and higher risk for incident HFpEF (HR: 1.28 [95% CI: 1.09-1.50]). Associations with incident HFrEF were not statistically significant. Lower ferritin levels were associated with higher E/e' ratio and higher pulmonary artery systolic pressure after adjustment for demographics and HF risk factors but not with measures of left ventricular structure or systolic function.
Conclusions: Among older adults without prevalent HF or anemia, lower plasma ferritin level is associated with a higher risk for incident HF, HFpEF, and higher measures of left ventricular filling pressure.
Competing Interests: Funding Support and Author Disclosures The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, U.S. Department of Health and Human Services, (contracts 75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, and 75N92022D00005). This work was supported in part by NHLBI grant R01 HL134320. Dr Buckley was supported by NHLBI grant K23HL150311, the BWH Khoury Innovation Fund, and an American Society of Nephrology/KidneyCure Carl W. Gottschalk Research Scholar Grant. Dr Shah was supported by NHLBI grants R01HL135008, R01HL143224, R01HL150342, R01HL148218, R01HL160025, and K24HL152008. Dr Lutsey was supported by NHLBI grant K24HL159246. Dr Shah has received research support (not related to this study) from Novartis and Philips Ultrasound; and has received consulting fees from Philips Ultrasound. Dr Farag is an employee of Bayer U.S. (not related to this study). Dr Lennep has received consulting fees from Pfizer (not related to this study). Dr Matsushita has received personal fee from Kyowa Kirin and Akebia (outside the submitted work). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Objectives: The aim of this study was to estimate the associations of plasma ferritin level with incident HF overall, HF phenotypes, and cardiac structure and function measures in older adults.
Methods: Participants in the ongoing, longitudinal ARIC (Atherosclerosis Risk In Communities) study who were free of prevalent HF and anemia were studied. The associations of plasma ferritin levels with incident HF overall and heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) were estimated using Cox proportional hazards regression models. Linear regression models estimated the cross-sectional associations of plasma ferritin with echocardiographic measures of cardiac structure and function.
Results: The cohort included 3,472 individuals with a mean age of 75 ± 5 years (56% women, 14% Black individuals). In fully adjusted models, lower ferritin was associated with higher risk for incident HF overall (HR: 1.20 [95% CI: 1.08-1.34] per 50% lower ferritin level) and higher risk for incident HFpEF (HR: 1.28 [95% CI: 1.09-1.50]). Associations with incident HFrEF were not statistically significant. Lower ferritin levels were associated with higher E/e' ratio and higher pulmonary artery systolic pressure after adjustment for demographics and HF risk factors but not with measures of left ventricular structure or systolic function.
Conclusions: Among older adults without prevalent HF or anemia, lower plasma ferritin level is associated with a higher risk for incident HF, HFpEF, and higher measures of left ventricular filling pressure.
Competing Interests: Funding Support and Author Disclosures The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, U.S. Department of Health and Human Services, (contracts 75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, and 75N92022D00005). This work was supported in part by NHLBI grant R01 HL134320. Dr Buckley was supported by NHLBI grant K23HL150311, the BWH Khoury Innovation Fund, and an American Society of Nephrology/KidneyCure Carl W. Gottschalk Research Scholar Grant. Dr Shah was supported by NHLBI grants R01HL135008, R01HL143224, R01HL150342, R01HL148218, R01HL160025, and K24HL152008. Dr Lutsey was supported by NHLBI grant K24HL159246. Dr Shah has received research support (not related to this study) from Novartis and Philips Ultrasound; and has received consulting fees from Philips Ultrasound. Dr Farag is an employee of Bayer U.S. (not related to this study). Dr Lennep has received consulting fees from Pfizer (not related to this study). Dr Matsushita has received personal fee from Kyowa Kirin and Akebia (outside the submitted work). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)