M Miller1, G M Hutchins. 1. Division of Cardiology, University of Maryland Medical System, Baltimore.
Abstract
OBJECTIVE: To examine the prevalence of coronary artery disease (CAD) in autopsies of patients with iron-overload syndromes. DESIGN: Retrospective autopsy study of CAD in cases of hemochromatosis and multiorgan hemosiderosis. SETTING: Registry of nearly 48,000 autopsies performed at The Johns Hopkins Hospital between 1889 and 1992. SUBJECTS: One hundred twenty-three subjects were studied. In a 2:1 control-case ratio, 82 controls matched by age, race, and sex were compared with 41 cases with iron overload. MAIN OUTCOME MEASURE: Severity of CAD. RESULTS: Pathological description of the coronary arteries were recorded as advanced or severe in 12% of iron-overload cases (n = 41) (mean age, 57.6 +/- 13.2 years) compared with 38% of controls (n = 82) (mean age, 57.0 +/- 13.8 years) (P = .01). The prevalence of three-vessel disease assessed by postmortem coronary arteriography was 11.1% in iron-overload cases (n = 18) (mean age, 61.7 +/- 12.2 years) compared with 33.3% in controls (n = 36) (mean age, 61.1 +/- 12.5 years) (P = .04). The odds ratio of CAD with iron overload was 0.18 (95% confidence interval, 0.04 to 0.73). CONCLUSIONS: Iron overload resulting from hemochromatosis or multiorgan hemosiderosis is not associated with an increased prevalence of CAD.
OBJECTIVE: To examine the prevalence of coronary artery disease (CAD) in autopsies of patients with iron-overload syndromes. DESIGN: Retrospective autopsy study of CAD in cases of hemochromatosis and multiorgan hemosiderosis. SETTING: Registry of nearly 48,000 autopsies performed at The Johns Hopkins Hospital between 1889 and 1992. SUBJECTS: One hundred twenty-three subjects were studied. In a 2:1 control-case ratio, 82 controls matched by age, race, and sex were compared with 41 cases with iron overload. MAIN OUTCOME MEASURE: Severity of CAD. RESULTS: Pathological description of the coronary arteries were recorded as advanced or severe in 12% of iron-overload cases (n = 41) (mean age, 57.6 +/- 13.2 years) compared with 38% of controls (n = 82) (mean age, 57.0 +/- 13.8 years) (P = .01). The prevalence of three-vessel disease assessed by postmortem coronary arteriography was 11.1% in iron-overload cases (n = 18) (mean age, 61.7 +/- 12.2 years) compared with 33.3% in controls (n = 36) (mean age, 61.1 +/- 12.5 years) (P = .04). The odds ratio of CAD with iron overload was 0.18 (95% confidence interval, 0.04 to 0.73). CONCLUSIONS:Iron overload resulting from hemochromatosis or multiorgan hemosiderosis is not associated with an increased prevalence of CAD.
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