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Iron Deficiency Anemia Prevalence at First Stroke or Transient Ischemic Attack

Published online by Cambridge University Press:  02 December 2014

Melanie D. Dubyk
College of Pharmacy and Nutrition, University of Saskatchewan
Robert T. Card
Division of Hematology, Department of Medicine, University of Saskatchewan
Susan J. Whiting
College of Pharmacy and Nutrition, University of Saskatchewan
Carol A. J. Boyle
Division of Neurology, Department of Medicine, University of Saskatchewan Stroke Prevention Clinic, Saskatoon Health Region, Saskatoon, Saskatchewan
Stanley H. Zlotkin
The Hospital for Sick Children, Departments of Pediatrics, Nutritional Sciences, and Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
Phyllis G. Paterson*
College of Pharmacy and Nutrition, University of Saskatchewan
College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, Saskatchewan, S7N 5C9, Canada.
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Iron deficiency anemia (IDA) has been implicated in the etiology of transient ischemic attack and ischemic stroke. This study aimed to: 1) document IDA prevalence in patients ≥ 65 years of age admitted to hospital with transient ischemic attack or first ischemic stroke, and 2) investigate dietary intake as a predictor of iron status.


Ninety-four patients were enrolled. An algorithm containing values for hemoglobin, ferritin, total iron binding capacity, transferrin saturation, and serum transferrin receptor measured at admission was used to identify IDA. Usual dietary intake was assessed with the Clue II food frequency questionnaire.


Prevalence estimates were 6.4% for IDA, 2.1% for iron deficiency without anemia, and 6.4% for anemia from other causes. IDA prevalence was significantly higher than published National Health and Nutrition Examination Survey III (NHANES III) estimates for gender-specific age groups ≥ 70 years (One-Sample Proportion Test; males p = 0.038 [n= 37]; females p = 0.002 [n=44]). A comparison of IDA prevalence against selected controls from the NHANES III database yielded an odds ratio (OR) of 6.3, 95% confidence interval (CI) 0.8 to 53.7, which was not statistically significant (Fisher's Exact Test; n=94; p = 0.118). Multivariate linear regression analysis of dietary intake with indicators of iron status (n=58) revealed only iron supplements (p = 0.013) and heme iron intake (p = 0.038) as negative predictors of total iron binding capacity (p<0.05).


These findings support the initiation of a prospective case control study to investigate IDA as a risk factor for ischemic stroke in elderly patients.

Research Article
Copyright © The Canadian Journal of Neurological 2012


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