European Primary Care Cardiovascular Society

Functional iron deficiency linked with incident CHD and mortality in the general population

Association of iron deficiency with incident cardiovascular diseases and mortality in the general population

Literature - Schrage B, Rübsamen N, Ojeda FM et al. - ESC Heart Fail. 2021 Oct 5. doi: 10.1002/ehf2.13589.

Functional iron deficiency is a relevant risk factor for CVD and mortality in the general population according to the authors of a study that investigated the relationship between iron deficiency and incident CVD and mortality.

Introduction and methods


Multiple studies have suggested that both absolute (AID) and functional iron deficiency (FID) are associated with morbidity and mortality in patients with CVD [1-4]. However, whether AID and FID are associated with incident coronary heart disease (CHD) in the general population remains uncertain.

Aim of the study

This study used data from three European cohort studies to investigate the association between AID, severe AID and FID with incident CHD and mortality in the general population.


The analysis included 12,164 individuals. Median age was 59 years and 45.2% were male. AID was defined as ferritin <100 µg/L, severe AID as ferritin <30 µg/L and FID as ferritin <100 µg/L or ferritin 100-299 µg/L and TSAT <20%.


Investigated outcomes were incident CHD, CV mortality, all-cause mortality and incident stroke. Median follow-up was 13.3 years.

Main results


FID was highly prevalent in the European population-based cohorts and associated with incident CHD, all-cause mortality and CV mortality after adjustment for multiple confounders. AID was only associated with incident CHD and severe AID only with all-cause mortality.

The authors of this article state: “these results underline the importance of TSAT measurement for diagnosis of ID and highlight FID as a relevant risk factor for CVD and mortality in the general population.”


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Find this article online at ESC Heart Fail.

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