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Hemochromatosis, multiorgan hemosiderosis, and coronary artery disease
1Division of Cardiology, University of Maryland Medical System, Baltimore.
Insights
This study found that iron overload from hemochromatosis or multiorgan hemosiderosis does not increase the risk of coronary artery disease (CAD). Autopsy data showed lower CAD prevalence in patients with iron overload compared to controls.
Area of Science:
- Cardiovascular Pathology
- Hematology
- Autopsy Studies
Background:
- Iron overload syndromes, including hemochromatosis and multiorgan hemosiderosis, are associated with various health complications.
- The potential link between iron overload and cardiovascular disease, specifically coronary artery disease (CAD), requires further investigation.
Purpose of the Study:
- To investigate the prevalence of coronary artery disease (CAD) in autopsies of patients diagnosed with iron-overload syndromes.
- To determine if conditions like hemochromatosis and multiorgan hemosiderosis are associated with a higher incidence of CAD.
Main Methods:
- A retrospective autopsy study was conducted using a registry of nearly 48,000 autopsies from The Johns Hopkins Hospital (1889-1992).
- Forty-one cases with iron overload were compared with 82 matched controls (2:1 ratio) based on age, race, and sex.
- The severity of coronary artery disease was the primary outcome measure, assessed through pathological examination and postmortem coronary arteriography.
Main Results:
- A significantly lower prevalence of advanced or severe coronary artery disease was observed in the iron-overload group (12%) compared to controls (38%) (P = .01).
- Postmortem coronary arteriography revealed a lower prevalence of three-vessel disease in iron-overload cases (11.1%) versus controls (33.3%) (P = .04).
- The odds ratio for CAD in patients with iron overload was 0.18, indicating a reduced likelihood of CAD in this cohort.
Conclusions:
- Iron overload, stemming from hemochromatosis or multiorgan hemosiderosis, is not associated with an increased prevalence of coronary artery disease.
- These findings suggest a potentially protective or non-contributory role of iron overload in the development of CAD.
Objective:
To examine the prevalence of coronary artery disease (CAD) in autopsies of patients with iron-overload syndromes.
Design:
Retrospective autopsy study of CAD in cases of hemochromatosis and multiorgan hemosiderosis.
Setting:
Registry of nearly 48,000 autopsies performed at The Johns Hopkins Hospital between 1889 and 1992.
Subjects:
One hundred twenty-three subjects were studied. In a 2:1 control-case ratio, 82 controls matched by age, race, and sex were compared with 41 cases with iron overload.
Main Outcome Measure:
Severity of CAD.
Results:
Pathological description of the coronary arteries were recorded as advanced or severe in 12% of iron-overload cases (n = 41) (mean age, 57.6 +/- 13.2 years) compared with 38% of controls (n = 82) (mean age, 57.0 +/- 13.8 years) (P = .01). The prevalence of three-vessel disease assessed by postmortem coronary arteriography was 11.1% in iron-overload cases (n = 18) (mean age, 61.7 +/- 12.2 years) compared with 33.3% in controls (n = 36) (mean age, 61.1 +/- 12.5 years) (P = .04). The odds ratio of CAD with iron overload was 0.18 (95% confidence interval, 0.04 to 0.73).
Conclusions:
Iron overload resulting from hemochromatosis or multiorgan hemosiderosis is not associated with an increased prevalence of CAD.