Iron status and survival in diabetic patients with coronary artery disease

Beata Ponikowska, Tomasz Suchocki, Bartłomiej Paleczny, Martyna Olesinska, Slawomir Powierza, Ludmila Borodulin-Nadzieja, Krzysztof Reczuch, Stephan Von Haehling, Wolfram Doehner, Stefan D. Anker, John G F Cleland, Ewa A. Jankowska

Research output: Contribution to journalArticlepeer-review


Objective-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.

Original languageEnglish
Pages (from-to)4147-4156
Number of pages10
JournalDiabetes Care
Issue number12
Publication statusPublished - Dec 2013

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing


Dive into the research topics of 'Iron status and survival in diabetic patients with coronary artery disease'. Together they form a unique fingerprint.

Cite this