Abstract 18440: Low Ferritin Levels are Associated With Increased Risk of Heart Failure - The Atherosclerosis Risk in Communities Study

Abstract

Introduction: While severe iron overload has been associated with cardiac damage, iron deficiency is related to worse outcomes in subjects with heart failure (HF).This study investigated the relationship between ferritin, a marker of iron status, and the incidence of HF in a general population based sample. Methods: We examined 1,063 participants from the Atherosclerosis Risk in Communities (ARIC) study, mean age 52±5 years, 62% women, free of heart failure, in whom ferritin serum levels were measured at baseline (1987-1989). The participants were categorized in low (200 ng/mL in women and >300 ng/mL in men; n=247) ferritin levels. Multivariable Cox proportional hazards models were used to evaluate the relationship between ferritin and incident HF. Results: At 20.9±4.6 years of follow-up, HF occurred in 144 (13.5%) participants. When compared with participants with normal ferritin, those with low level had a higher risk of HF (HR 2.10, 95%CI 1.27-3.47; p=0.004), while there was no significant difference between those with normal and high ferritin levels (HR= 1.07, 95%CI= 0.71-1.63, p=0.7), after adjusting for potential confounders. Low ferritin levels remained associated with incident HF in subjects without anemia (HR= 2.06, 95%CI= 1.18-3.61, p=0.01). (Figure) Conclusion: Low ferritin levels are associated with a higher risk of incident HF. These findings suggest that iron deficiency might play a role in the development of HF.