Serum ferritin levels may have a pro-atherosclerotic role in coronary artery disease patients with sleep disordered breathing

Elevated ferritin levels may lead to oxidative stress, and are associated with coronary artery disease (CAD). Sleep disordered breathing (SDB) is frequently present in atherosclerosis patients, and causes endothelial dysfunction leading to atherosclerotic plaque progression. Hypoxic conditions, such as SDB, may upregulate ferritin. The aim of this study was to evaluate ferritin levels in CAD patients and to correlate ferritin levels with parameters related to CAD progression, including SDB. We studied 27 patients with CAD (defined as >30% coronary narrowing) and 29 controls. We found that ferritin was increased in CAD patients, and was positively correlated with the apnea–hypopnea index (AHI), age, C-reactive protein (CRP), transferrin, hemoglobin, and testosterone levels, and was negatively correlated with O2 saturation. Nitrites and nitrates, an indirect measure of nitric oxide (NO) concentration, were lower in CAD patients, and were negatively correlated with ferritin. The increase in ferritin may be related to oxidative stress, suggesting a possible pro-atherosclerotic role of increased ferritin in CAD patients with SDB.