Hemochromatosis, multiorgan hemosiderosis, and coronary artery disease

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.