{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:19:52Z","timestamp":1772461192533,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2009,12,14]],"date-time":"2009-12-14T00:00:00Z","timestamp":1260748800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While the role of hemoglobin in heart failure and renal disease has been investigated, little is known about its effect on clinical exercise test performance and mortality in patients referred for routine exercise treadmill testing (ETT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Patients with low hemoglobin will have poor exercise capacity and would be at increased risk of mortality and cardiovascular (CV) events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical variables, laboratory values, and exercise treadmill data were obtained for 1,799 patients referred for routine ETT from 1997 to 2004. All\u2010cause mortality was obtained from the United States Social Security death index and autopsy reports or clinical notes were used to determine CV events and mortality. P values &lt; 0.05 were considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our population had a mean age of 58 \u00b1 12 years, 16% had diabetes, 53% had hypertension, 35% had hypercholesterolemia, and 67% had a history of smoking. During follow\u2010up, 10.3% of patients died, 3.9% of patients died of CV causes, and 11.6% had cardiovascular events. Anemic patients (hemoglobin [Hgb] &lt; 13 g\/dL) achieved lower metabolic equivalents (METs) than nonanemic patients and had more ST\u2010segment depression (15.5% versus 8.6%, p &lt; 0.004). Proportional hazard analysis demonstrated that hemoglobin was significantly associated with all\u2010cause mortality (p &lt; 0.0007), CV mortality (p &lt; 0.009), and CV events (p &lt; 0.01). Kaplan\u2010Meier survival analysis demonstrated that anemic patients had significantly higher mortality and CV events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hemoglobin is significantly associated with exercise performance, ST\u2010segment depression during ETT, mortality, and cardiovascular events. The incorporation of hemoglobin may add diagnostic and prognostic information to ETT. Copyright \u00a9 2009 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.20418","type":"journal-article","created":{"date-parts":[[2009,12,14]],"date-time":"2009-12-14T21:23:12Z","timestamp":1260825792000},"source":"Crossref","is-referenced-by-count":12,"title":["Hemoglobin Levels Predict Exercise Performance, ST\u2010Segment Depression, and Outcome in Patients Referred for Routine Exercise Treadmill Testing"],"prefix":"10.1002","volume":"32","author":[{"given":"Michael J.","family":"Lipinski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick E.","family":"Dewey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe G.","family":"Biondi\u2010Zoccai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Abbate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George W.","family":"Vetrovec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor F.","family":"Froelicher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,12,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.3.1003"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.6.1933"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.120967"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011858"},{"issue":"1","key":"e_1_2_1_6_2","first-page":"S93","article-title":"The cardio renal anemia syndrome: Correcting anemia in patients with resistant congestive heart failure can improve both cardiac and renal function and reduce hospitalizations","volume":"60","author":"Silverberg DS","year":"2003","journal-title":"Clin Nephrol"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01854-5"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00200.x"},{"issue":"4","key":"e_1_2_1_9_2","first-page":"362","article-title":"Hemodynamic and ECG responses to exercise in children with sickle cell anemia","volume":"135","author":"Alpert BS","year":"1981","journal-title":"Am J Dis Child"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02724008"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.300.6724.573"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000044914.42696.6A"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90496-8"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000187026"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.19.2214"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000134964.01697.C7"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.08.015"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000162477.70955.5F"},{"key":"e_1_2_1_19_2","first-page":"5","article-title":"Nutritional anaemias. 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