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Assessment of haemoglobin and serum markers of iron deficiency in people with cardiovascular disease
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    Re: Assessment of haemoglobin and serum markers of iron deficiency in people with cardiovascular disease

    Graham et al. reported the prevalence of anaemia and iron deficiency in patients with cardiovascular disease, aged ≥50 years (1). Prevalence of anaemia in patients with and without heart failure were 46%, and 29%, respectively. In addition, low haemoglobin and transferrin saturation, but not low ferritin, were associated with a worse prognosis. I have two comments.

    First, Mahendiran et al. reported that patients with acute coronary syndromes (ACS) and anaemia at admission was significantly associated with 1-year all-cause mortality and cardiovascular events (2). Colombo et al. also conducted a prospective study, with median follow-up of 4.9 years, to investigate the relationship between anaemia and cardiovascular events in patients with ACS (3). The adjusted hazard ratio (95% confidence intervals [CI]) of patients with anaemia at admission against patients without anaemia throughout admission for was 1.51 (1.02-2.25). I suppose that the severity of ACS, including progression of heart failure, may also be closely related to subsequent prognosis.

    Second, Graham et al. made an emphasis that anaemia would contribute to a worse prognosis in patients with cardiovascular disease (1). Salisbury et al. reported the risk of in-hospital mortality in relation to anaemia after hospitalization in patients with acute myocardial infarction (4). When the severity of anaemia was classified into three levels of haemoglobin, mild (>11 g/dL), moderate (9-11 g/dL), and severe...

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    Conflict of Interest:
    None declared.