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CORRESPONDENCE: LETTER TO THE EDITOR

Anemia in Patients With Advanced Heart Failure

^_* 2C2 Cardiology WMC, University of Alberta, 8440 112 Street, Edmonton, Alberta T6G 2B7, Canada (Email: jae2{at}ualberta.ca).

Defining anemia as "clinically significant" deviates from other standardized definitions—the World Health Organization (2) or Centers for Disease Control and Prevention criteria (3)—with implications for anemia prevalence. In addition, surveillance bias seems likely as only 2 of 37 patients were female derived from an unknown denominator.

The ferritin concentration used by the investigators (<17 ng/ml, 38 pmol/l) is lower than other surveys (4) and expert reviews (5), hence, had a different threshold been applied, additional patients with iron deficiency anemia may have been discovered. Finally, the meaning of "the absence of iron stores" in the bone marrow is unclear without quantification or reporting of the stain used or inter-reader reliability. Additional data on the saturation index and correlation of serum markers with histological bone marrow findings would be most useful to other researchers in this area and potentially enhance the clinical applicability of the data.

	References

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1. Nanas JN, Matsouka C, Karageorgopoulos D, et al. Etiology of anemia in patients with advanced heart failure J Am Coll Cardiol 2006;48:2485-2489.[Abstract/Free Full Text]
2. WHO Scientific Group Nutritional anaemiasReport of a WHO scientific group. World Health Organ Tech Rep Ser 1968;405:5-37.[Medline]
3. Adamson J. Anemia of acute and chronic inflammation/infection (the anemia of chronic disease)In: Braunwald E, Fauci AS, Isselbacher KJ, et al. editors. Harrison’s Principle’s of Internal Medicine. 15th edition. New York, NY: McGraw-Hill; 2001.[Abstract/Free Full Text]
4. Ezekowitz JA, McAlister FA, Armstrong PW. The interaction among sex, hemoglobin and outcomes in a specialty heart failure clinic Can J Cardiol 2005;21:165-171.[ISI][Medline]
5. Weiss G, Goodnough LT. Anemia of chronic disease N Engl J Med 2005;352:1011-1023.[Free Full Text]

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This Article Full Text (PDF) All Versions of this Article: j.jacc.2007.04.004v1 49/23/2301    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ezekowitz, J. A. Search for Related Content PubMed Articles by Ezekowitz, J. A. Related Collections Related Article