Haem Iron Intake Is Associated with Increased Major Adverse Cardiovascular Events, All-Cause Mortality, Congestive Cardiac Failure, and Coronary Revascularisation in Older Men: The Concord Health and Ageing in Men Project - 10/12/24

Doi : 10.1007/s12603-023-1945-6 
Rebecca Luong 1, 2, 3 , R.V. Ribeiro 3, 4, A. Rangan 1, 3, V. Naganathan 5, 6, F. Blyth 2, 7, L.M. Waite 5, 6, D.J. Handelsman 8, 9, D.G. Le Couteur 3, 8, M.J. Seibel 6, 8, V. Hirani 1, 2, 3, 5
1 Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia 
2 ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, Sydney, NSW, Australia 
3 Level 4, Charles Perkins Centre D17, University of Sydney, 2006, Sydney, NSW, Australia 
4 School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney, NSW, Australia 
5 Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia 
6 Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia 
7 School of Public Health, The University of Sydney, Sydney, NSW, Australia 
8 ANZAC Research Institute, The University of Sydney and Concord Hospital, Concord, NSW, Australia 
9 Andrology Department, Concord Hospital, Concord, NSW, Australia 

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Abstract

Background

Nutritional intake can influence major adverse cardiovascular events (MACE). Dietary iron is found in two forms: haem-iron (HI) only found in animal sources and non-haem iron (NHI) present mostly in plant sources.

Objective

We evaluated the associations between dietary iron intakes with MACE and iron status biomarkers.

Design

Prospective cohort study.

Setting

The Concord Health and Ageing in Men Project, Sydney, Australia.

Participants

539 community-dwelling older Australian men aged 75 years and older.

Methods

Men underwent nutritional assessment using a validated diet history questionnaire. Entries were converted to food groups and nutrients. The dietary calculation was used to derive HI and NHI intakes from total iron intakes. Analyses of iron intakes with iron status biomarkers were conducted using linear regression, and with MACE and individual endpoints were conducted using Cox regression. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality.

Results

At a median of 5.3 (4.6–6.3) years follow-up, the incidences were: 31.2% (n = 168) five-point MACE, 17.8% (n = 96) four-point MACE excluding all-cause mortality, 20.1% (n = 111) all-cause mortality, 11.3% (n = 61) CCF, and 3.1% (n = 15) coronary revascularisation. In adjusted analyses, higher HI intake (per 1mg increment) was associated with increased five-point MACE (HR: 1.45 [95% CI: 1.16, 1.80, P =.001]), four-point MACE excluding all-cause mortality (HR: 1.64 [95% CI: 1.26, 2.15, P <.001]), all-cause mortality (HR: 1.51 [95% CI: 1.15, 1.99, P =.003]), CCF (HR: 2.08 [95% CI: 1.45, 2.98, P <.001]), and coronary revascularisation (HR: 1.89 [95% CI: 1.15, 3.10, P =.012]). Compared with the bottom tertile of NHI intake, the middle tertile of NHI intake was associated with reduced risk of all-cause mortality (HR: 0.56 [95% CI: 0.33, 0.96, P =.035]). Total iron intake was not associated with MACE and individual endpoints. Dietary iron intakes were not associated with serum iron and haemoglobin.

Conclusion

Higher haem iron intake was independently associated with increased risks of five-point MACE, four-point MACE excluding all-cause mortality, all-cause mortality, CCF, and coronary revascularisation in older men over 5 years.

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Key words : Dietary iron, old men, mortality, coronary artery disease, heart failure


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Vol 27 - N° 7

P. 559-570 - juillet 2023 Retour au numéro
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