Key result
Elevated catalytic iron is linked to a ~6-fold increase in CAD among hemodialysis patients.
Why the study?
Cardiovascular disease is the leading cause of morbidity and mortality in maintenance hemodialysis patients, and the role of serum catalytic iron as a biomarker for coronary artery disease in this population was evaluated.
Is elevated serum catalytic iron associated with the presence of significant coronary artery disease in patients on maintenance hemodialysis?
Cross-Sectional (n=59)
No
Is elevated serum catalytic iron associated with the presence of significant coronary artery disease in patients on maintenance hemodialysis?
Elevated serum catalytic iron is independently associated with the presence of significant coronary artery disease in patients on maintenance hemodialysis, particularly in those with diabetes.
Catalytic iron may mark CAD risk in hemodialysis; hypothesis-generating and should not yet change practice.
Cardiovascular disease is the leading cause of morbidity and mortality in maintenance hemodialysis (MHD) patients. We evaluated the role of serum catalytic iron (SCI) as a biomarker for coronary artery disease (CAD) in patients on MHD. SCI was measured in 59 stable MHD patients. All patients underwent coronary angiography. Significant CAD was defined as a > 70% narrowing in at least one epicardial coronary artery. Levels of SCI were compared with a group of healthy controls. Significant CAD was detected in 22 (37.3%) patients, with one vessel disease in 14 (63.63%) and multi-vessel disease in eight (36.36%) patients. The MHD patients had elevated levels of SCI (4.70 ± 1.79 μmol/L) compared with normal health survey participants (0.11 ± 0.01 μmol/L) (P < 0.0001). MHD patients who had no CAD had SCI levels of 1.36 ± 0.34 μmol/L compared with those having significant CAD (8.92 ± 4.12 μmol/L) (P < 0.0001). Patients on MHD and diabetes had stronger correlation between SCI and prevalence of CAD compared with non-diabetics. Patients having one vessel disease had SCI of 8.85 ± 4.67 μmol/L versus multi-vessel disease with SCI of 9.05 ± 8.34 μmol/L, P = 0.48. In multivariate analysis, SCI and diabetes mellitus were independently associated with significant CAD. We confirm the high prevalence of significant CAD in MHD patients. Elevated SCI levels are associated with presence of significant coronary disease in such patients. The association of SCI is higher in diabetic versus the non-diabetic subgroup. This is an important potentially modifiable biomarker of CAD in MHD patients.
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Rajapurkar et al. (2013) conducted a cross-sectional in Coronary artery disease in end-stage kidney disease on maintenance hemodialysis (n=59). Serum catalytic iron vs. Patients without significant coronary artery disease was evaluated on Serum catalytic iron levels in patients with significant coronary artery disease compared to those without (p=<0.0001). Elevated serum catalytic iron levels were significantly associated with the presence of significant coronary artery disease in patients on maintenance hemodialysis (8.92 vs 1.36 μmol/L, p<0.0001).
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