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Homocyst(e)ine and Cardiovascular Disease
- John W. Eikelboom, MBBS, FRACP;
- Eva Lonn, MD, FRCPC; and
- Salim Yusuf, MBBS, DPhil, FRCPC
- McMaster University; Hamilton, Ontario L8L 2X2, Canada (Eikelboom) McMaster University; Hamilton, Ontario L8L 2X2, Canada (Lonn) McMaster University; Hamilton, Ontario L8L 2X2, Canada (Yusuf)
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IN RESPONSE:
To our knowledge, incidence of cardiovascular disease in patients with pernicious anemia has not been specifically examined. However, although folate is the most important determinant of plasma homocyst(e)ine, there is clearly also an inverse relation between cobalamin and plasma homocyst(e)ine (1). Pernicious anemia is the most common cause of cobalamin deficiency (2), and because the plasma homocyst(e)ine level is elevated in more than 95% of patients with pernicious anemia (3), an increased risk for cardiovascular disease might reasonably be expected in patients with pernicious anemia if an elevated homocyst(e)ine level is truly causally associated with an increased risk for cardiovascular disease. However, the causal nature of this association remains to be confirmed.
John W. Eikelboom, MBBS, FRACP
McMaster University; Hamilton, Ontario L8L 2X2, Canada
Eva Lonn, MD, FRCPC
McMaster University; Hamilton, Ontario L8L 2X2, Canada
Salim Yusuf, MBBS, DPhil, FRCPC
McMaster University; Hamilton, Ontario L8L 2X2, Canada
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
