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Paul C. Hébert, MD, MHSc; Dean A. Fergusson, PhD

JAMA. 2004;292:1610-1612.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Over the last half-century, it has become well recognized that patients with cardiovascular diseases and, more specifically, ischemic heart disease may be adversely affected by anemia. This is because the myocardium consumes or extracts 60% to 75% of all oxygen delivered to the coronary circulation.^1-3 Such an elevated extraction of oxygen, termed extraction ratio, is unique to the coronary circulation. As a result, oxygen delivery to the myocardium can be augmented only by increasing blood flow or oxygen content.¹

Animal and human studies have investigated the effects of normovolemic anemia on coronary circulation.^1-2,4-5 There appear to be minimal consequences from moderate levels of anemia with hemoglobin levels in the range of 7.0 g/dL if coronary circulation is normal.^{1, 6-9} However, at comparable hemoglobin concentrations, myocardial dysfunction and ischemia occur earlier and are more pronounced in anemic animal models with moderate- to high-grade . . . [Full Text of this Article]

Author Affiliations: University of Ottawa Centre for Transfusion and Critical Care Research and Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario.

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