Abstract P305: Prospective Associations of Serum Ferritin Levels With Cardiovascular Disease Incidence Among African Americans: The Jackson Heart Study
Introduction: The role of inflammation in vascular endothelial remodeling initiating and propagating atherosclerosis has been well documented. There has been conflicting results regarding the role of ferritin, a nonspecific marker for systemic inflammation, in identifying high risk patients for cardiovascular disease (CVD) incidence. We thus investigated the association of ferritin with CVD incidence and subclinical measures of atherosclerosis among African Americans (AA), with the hypothesis that there is a direct association between ferritin and incident CVD events, and a putative effect measure modification by cholesterol levels.
Methods: We measured serum ferritin levels at baseline visit (2000 - 2004) in 4,679 AA participants enrolled in the Jackson Heart Study. Sex-specific, age-adjusted correlations, multivariable linear and proportional hazards regression models were used to assess the cross-sectional and longitudinal associations of ferritin with carotid intima-media thickness, coronary artery calcium, abdominal aortic calcium and time to incident coronary heart disease and stroke.
Results: The mean (standard deviation) ferritin level among study participants was 131 (± 135) ng/mL among women and 235 (± 207) ng/mL among men. Ferritin was moderately and significantly associated with abdominal aortic calcium (r = 0.09) among women, but not among men. During an average seven years of follow-up, 158 incident events and 116 incident stroke events were documented. Among participants with total cholesterol levels above 200 mg/dL, there was a reduced risk of incident stroke among those in the third quartile as compared to the lowest quartile, hazard ratio HR = 0.34 (CI 0.14 - 0.80) when adjusting for age, but not among those with normal levels of cholesterol (p-value for interaction of 0.03). The association disappeared when additionally adjusting for sex, BMI, smoking status, alcohol intake, physical activity, systolic blood pressure and antihypertensive medication (p for trend, 0.30). There was not an increased risk of incident coronary heart disease in relationship with higher ferritin levels, regardless of total cholesterol levels.
Conclusion: Cholesterol level interacts with ferritin in its association with risk of stroke incidence among African Americans. A higher serum ferritin level is not associated with a higher risk of incident stroke or incident coronary heart disease. Serum ferritin level does not appear to predict CVD incidence in African Americans despite its slight association with abdominal aortic calcium among women.
Author Disclosures: B. Renelus: None. H.R. Millard: None. M. Axiyan: None. S.K. Musani: None. E.R. Fox: None. J. Liu: None. H.A. Taylor: None. A. Bidulescu: None.
- © 2015 by American Heart Association, Inc.