Implementation of an iron reduction protocol in patients with peripheral vascular disease: VA cooperative study no. 410: the Iron (Fe) and Atherosclerosis Study (FeAST)

American Heart Journal
L R ZacharskiGalina Shamayeva

Abstract

Iron accumulates imperceptibly over time in adults because intake exceeds loss and because no physiologic mechanism exists for excreting levels that may be toxic. Levels of stored iron represented by the serum ferritin concentration have been implicated in the pathogenesis of vascular (and other) diseases, but the role of such stored iron remains controversial. Our hypothesis was that reduction in body iron stores to levels typical of children and premenopausal women (corresponding to ferritin levels of approximately 25 ng/mL) would alter morbidity and mortality rates in patients with advanced peripheral vascular disease. A randomized, single-blinded, clinical trial of graded reduction of iron stores by controlled phlebotomy was undertaken in patients with advanced peripheral vascular disease. Details of implementation of the protocol for testing this unusual experimental intervention are reported. A methodology is described for testing the concept that reduction of body iron stores (while avoiding iron deficiency) may alter disease outcomes. This methodology appears to be suitable for further testing to determine whether levels of iron stores presumed to be pathologic contribute to disease initiation or progression.

References

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Citations

Dec 15, 2010·Rejuvenation Research·Maximus V Peto
Jul 10, 2008·Journal of the National Cancer Institute·Leo R ZacharskiPhilip W Lavori
Aug 24, 2007·Expert Opinion on Pharmacotherapy·Leo R Zacharski, Cocav A Engman
Jul 10, 2007·Journal of the American College of Surgeons·Ralph G DePalmaLeo R Zacharski
Mar 8, 2005·Journal of Thrombosis and Haemostasis : JTH·L R Zacharski
May 9, 2006·Free Radical Biology & Medicine·Leo R Zacharski, Cocav A Engman
Jun 18, 2005·Arteriosclerosis, Thrombosis, and Vascular Biology·Haoyi ZhengStuart D Katz
Aug 28, 2007·Experimental Biology and Medicine·Jerome L Sullivan

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