Relationship between serum ferritin and the risk of all-cause death in patients with coronary artery disease

Ferritin is independently associated with oxidized Low-Density Lipoprotein (LDL). While high LDL levels are known independent risk factors for cardiovascular diseases, few studies have investigated the relationship between serum ferritin levels and long-term outcomes in CAD patients. A prospective cohort study of CAD participants was performed in Xinjiang Medical University Affiliated First Hospital from December 2016 to October 2021. 1089 CAD patients were divided into two groups according to baseline serum ferritin concentration (ferritin < 160, n = 715 and ferritin ≥ 160, n = 374). The authors investigated long-term mortality as the primary endpoint, including All-Cause Mortality (ACM) and Cardiac Mortality (CM). The longest follow-up duration was 60 months. In this study, a total of 17 ACMs, 12 CMs, 34 MACEs, and 41 MACCEs were recorded. There were significant differences between the two groups in the incidence of ACM (p = 0.002) and CM (p = 0.019). After controlling for covariates, multivariate Cox regression analysis showed that ferritin was an independent predictor ACM (Hazard Ratio [HR = 2.674], 95 % Confidence Interval [95 % CI 1.197‒5.971], p = 0.016) in CAD patients. High ferritin levels are strongly associated with a higher risk of ACM in CAD patients.