Impact of Iron Deficiency on Peripheral Artery Disease After Endovascular Therapy

Area of Science:

• Cardiology
• Vascular Medicine
• Hematology

Background:

• Peripheral artery disease (PAD) poses significant cardiovascular risks despite endovascular therapy (EVT).
• The association between iron deficiency (ID) and PAD severity or clinical outcomes remains under-investigated.
• Iron deficiency is known to impact outcomes in other cardiovascular conditions.

Purpose of the Study:

• To investigate the relationship between iron deficiency and the severity of peripheral artery disease.
• To determine if iron deficiency impacts major adverse cardiovascular and leg events (MACLE) and major adverse cardiovascular events (MACE) in PAD patients treated with EVT.

Main Methods:

• A cohort of 449 patients with PAD undergoing EVT were assessed for iron status (transferrin saturation [TSAT] <20% defined ID) and red blood cell measurements.
• Patients were followed for a median of 1,064 days to record MACLE and MACE.
• Statistical analyses included Kaplan-Meier and multivariate Cox regression models.

Main Results:

• TSAT and hemoglobin levels correlated inversely with PAD severity (Fontaine class).
• Patients with ID exhibited significantly higher rates of MACE and MACLE compared to those without ID.
• TSAT was identified as an independent predictor of MACLE, and its addition improved risk prediction models.

Conclusions:

• Iron deficiency, identified by low TSAT, is associated with increased disease severity and adverse clinical outcomes in PAD patients.
• TSAT emerges as a significant prognostic marker for MACLE in PAD.
• Targeting iron deficiency presents a potential therapeutic strategy to improve outcomes in peripheral artery disease.