Association between serum ferritin and acute coronary heart disease: A population-based cohort study

Several studies aiming to determine the association between iron stores and coronary heart disease (CHD) have reported conflicting results. None of them has been performed in a Mediterranean region. Our aim is to assess the association between the level of serum ferritin and the incidence of CHD in a Mediterranean region. We performed a cohort study using a primary health care population database. Primary outcome was incidence of CHD. Subjects aged between 35 and 74 years with serum ferritin (SF) measurements at baseline (January 1, 2006 to December 31, 2008) were included. Cox regression models were used to compute hazard ratios (HRs) and 95%CIs for the associtation between SF and time until CHD outcome. We include 242,084 subjects with SF levels at baseline. Participants were observed for a median of 8.4 years. During follow-up, 1106 incident cases of CHD were identified. Persons with elevated SF did not have an increased CHD risk at follow-up (adjusted hazard ratio = 0.99; 95%CI 0.94–1.05; p = 0.86 in men, and 0.95; 95%CI 0.81–1.13; p = 0.60 in women). Our study, by far the largest, showed that high levels of SF do not confer an increased risk of CHD, and questions its role as a risk factor for this disease. [Display omitted] •High levels of serum ferritin do not confer an increased risk of coronary heart disease (CHD) in a Mediterranean population.•Protective effect of levels of serum ferritin over 30 for CHD disappeared once analyzing ferritin continuously.•The analysis using continuous ferritin levels is a better reflection of reality.