Value of serum ferritin and soluble transferrin receptor for prediction of coronary artery disease and its clinical presentations

We investigated whether there is an association between serum ferritin or soluble transferrin receptor (sTfR) concentrations and coronary artery disease (CAD) or its clinical presentations. This is a case-control study that included 892 patients (664 cases with angiographically proven CAD and 228 controls without CAD). Blood was collected before angiography for determination of sTfR, ferritin and C-reactive protein (CRP). The values (median, 25th-75th percentiles) of sTfR (2.6 [2.1; 3.2] mg/l versus 2.4 [2.1; 3.0] mg/l, P=0.13) or ferritin (140.1 [74.8; 248.3] ng/ml versus 120.1 [74.9; 218.0] ng/ml, P=0.11) did not differ significantly between cases or controls. The values of sTfR in the case subjects with 1-vessel, 2-vessel, and 3-vessel CAD were: 2.4 [2.0; 3.0], 2.6 [2.0; 3.2], and 2.8 [2.2; 3.3] mg/l, respectively (P=0.003). In multivariate analysis, neither sTfR (χ²=0.14, P=0.70) nor ferritin (χ²=2.8, P=0.09) correlated independently with the presence of CAD. In case subjects with stable angina, unstable angina, and acute myocardial infarction (MI), ferritin concentrations were: 127.5 [69.5; 214.0], 138.9 [86.1; 278.0], and 175.0 [93.5; 314.5] ng/ml, respectively (P<0.001). Our results showed that serum concentrations of sTfR or ferritin do not predict the risk for coronary artery disease. In subjects with pre-existing CAD, those with more severe disease had increased levels of sTfR. Patients with CAD presenting with acute coronary syndromes showed increased levels of serum ferritin.