Bone marrow iron depletion is common in patients with coronary artery disease

Jankowska, E. A. et al. (2015) Bone marrow iron depletion is common in patients with coronary artery disease. International Journal of Cardiology, 182, pp. 517-522. (doi: 10.1016/j.ijcard.2014.10.006) (PMID:25661858)

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Background/objectives: 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 ≥ 1.32 mg/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.

Item Type:Articles
Additional Information:This research was financially supported by the unrestricted grant from Vifor Pharma given to Wroclaw Medical University (registered as the statutory project of Department of Heart Diseases U-2170) and the grant from Polish Society of Cardiology (PI: EAJ).
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Jankowska, E. A., Wojtas, K., Kasztura, M., Mazur, G., Butrym, A., Kalicinska, E., Rybinska, I., Skiba, J., von Haehling, S., Doehner, W., Anker, S. D., Banasiak, W., Cleland, J. G.F., and Ponikowski, P.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:International Journal of Cardiology
ISSN (Online):1874-1754
Published Online:08 October 2014

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