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June 1963

PhlebotomyUse in Patients with Erythrocytosis and Ischemic Heart Disease

Arch Intern Med. 1963;111(6):687-695. doi:10.1001/archinte.1963.03620300007003

It has been known for some time that patients with polycythemia vera are predisposed to angina pectoris and myocardial infarction.1 A recent study described a group of patients with angina pectoris or acute myocardial infarction, or both, who had moderate erythrocytosis but in whom hematologic studies failed to demonstrate any evidence of polycythemia vera.2 Reduction of the hematocrit by phlebotomy decreased the frequency of anginal attacks in some patients. In an effort to learn the relationship of hematocrit to myocardial infarction the hematocrit levels of 100 men and 120 women with acute myocardial infarction were compared with those of age-matched subjects without clinical evidence of coronary artery disease.3,4 It was found that the hematocrit levels for the men and women with acute myocardial infarction were significantly higher than those for the control subjects (Fig. 1).

The purpose of this paper is to present evidence that phlebotomy may