Iron is essential in terms of
oxygen utilization and mitochondrial function. The liver-derived
peptide hepcidin has been recognized as a key regulator of
iron homeostasis. Since
iron metabolism is crucially linked to cardiovascular health, and low
hepcidin was proposed as potential new marker of
iron metabolism, we aimed to evaluate the prognostic value of
hepcidin in a large cohort of patients with
coronary heart disease (CHD). Serum levels of
hepcidin were determined at baseline in patients with angiographically documented CHD. The main outcome measure was non-fatal
myocardial infarction (MI) or cardiovascular death. During a median follow-up of 4.1 years, 10.3% experienced an endpoint. In Cox regression analyses for
hepcidin the hazard ratio for future cardiovascular death or MI was 1.03 (95% confidence interval (CI) 0.91⁻1.18, p = 0.63) after adjustment for sex and age. This association virtually did not change after additional adjustment for body mass index (BMI), smoking status,
hypertension, diabetes,
dyslipidemia, and surrogates of cardiac function (
NT-proBNP), size of myocardial
necrosis (
troponin I), and
anemia (
hemoglobin). In this study, by far the largest evaluating the predictive value of
hepcidin,
hepcidin levels were not associated with future MI or cardiovascular death. This implicates a limited, if any, role for
hepcidin in secondary cardiovascular risk prediction.