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Objectives <p>Elevated serum ferritin levels predict adverse outcomes in many autoimmune diseases. However, its clinical significance in Takayasu arteritis (TAK) is not clear. This study aimed to evaluate the predictive value of serum ferritin for major adverse cardiovascular events (MACEs) in TAK.</p> Method <p>A two-center retrospective cohort study was conducted. A total of 189 treatment-naïve TAK patients who underwent serum ferritin testing at baseline were consecutively enrolled and followed longitudinally. The association between serum ferritin levels and adverse events was assessed using survival analyses.</p> Results <p>Thirty-seven patients (19.6%) experienced MACEs during a median follow-up of 34.00 (20.00–55.00) months. Using the cut-off value of 68.6 μg/L, patients with high serum ferritin levels exhibited significantly higher MACE rates at 12, 36, 60, and 96 months compared to those with low levels (χ2 = 8.59, P = 0.003; χ2 = 15.23, P &lt; 0.001; χ2 = 11.48, P &lt; 0.001; χ2 = 12.63, P &lt; 0.001, respectively). Serum ferritin was an independent predictor of MACEs in TAK at 96 months, both when analyzed as a continuous variable (HR: 1.003, 95% CI: 1.001–1.006, P = 0.007) and as a categorical variable (HR: 2.609, 95% CI: 1.280–5.320, P = 0.008). Furthermore, the predictive value of serum ferritin remained consistent across most subgroups, except among male patients (P for interaction = 0.018, P &gt; 0.05), smokers (P for interaction = 0.027, P &gt; 0.05) and patients receiving glucocorticoids (P for interaction = 0.033, P &gt; 0.05).</p> Conclusions <p>Elevated serum ferritin is an independent predictor of MACEs in TAK. Patients with increased baseline serum ferritin levels should undergo close monitoring and may benefit from intensified therapeutic interventions due to their higher risk of adverse events.</p> <p><Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> <p><b>Key Points</b></p> <p><i>• Elevated Serum ferritin is associated with poorer prognosis in Takayasu arteritis.</i></p> <p><i>• Serum ferritin is an independent prognostic biomarker in Takayasu arteritis.</i></p> <p><i>• The predictive value of serum ferritin is consistent across most subgroups.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>

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Serum ferritin as a predictor of major adverse cardiovascular events in Takayasu arteritis: a two-center retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年7月4日

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  • Weiping Ci,
  • Fang Kong,
  • Juan Du,
  • Yaxin Zhang,
  • Yi Zhao,
  • Lili Pan

摘要

Objectives

Elevated serum ferritin levels predict adverse outcomes in many autoimmune diseases. However, its clinical significance in Takayasu arteritis (TAK) is not clear. This study aimed to evaluate the predictive value of serum ferritin for major adverse cardiovascular events (MACEs) in TAK.

Method

A two-center retrospective cohort study was conducted. A total of 189 treatment-naïve TAK patients who underwent serum ferritin testing at baseline were consecutively enrolled and followed longitudinally. The association between serum ferritin levels and adverse events was assessed using survival analyses.

Results

Thirty-seven patients (19.6%) experienced MACEs during a median follow-up of 34.00 (20.00–55.00) months. Using the cut-off value of 68.6 μg/L, patients with high serum ferritin levels exhibited significantly higher MACE rates at 12, 36, 60, and 96 months compared to those with low levels (χ2 = 8.59, P = 0.003; χ2 = 15.23, P < 0.001; χ2 = 11.48, P < 0.001; χ2 = 12.63, P < 0.001, respectively). Serum ferritin was an independent predictor of MACEs in TAK at 96 months, both when analyzed as a continuous variable (HR: 1.003, 95% CI: 1.001–1.006, P = 0.007) and as a categorical variable (HR: 2.609, 95% CI: 1.280–5.320, P = 0.008). Furthermore, the predictive value of serum ferritin remained consistent across most subgroups, except among male patients (P for interaction = 0.018, P > 0.05), smokers (P for interaction = 0.027, P > 0.05) and patients receiving glucocorticoids (P for interaction = 0.033, P > 0.05).

Conclusions

Elevated serum ferritin is an independent predictor of MACEs in TAK. Patients with increased baseline serum ferritin levels should undergo close monitoring and may benefit from intensified therapeutic interventions due to their higher risk of adverse events.

Key Points

• Elevated Serum ferritin is associated with poorer prognosis in Takayasu arteritis.

• Serum ferritin is an independent prognostic biomarker in Takayasu arteritis.

• The predictive value of serum ferritin is consistent across most subgroups.