Hemoglobin Kinetics and Long-term Prognosis in Heart Failure

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• 作者：Carles Dí ; ez-Ló ; pezup>aup> ; Josep Lupó ; nup>aup>up> ; up>up>bup> ; Marta de Antonioup>aup> ; Elisabet Zamoraup>aup>up> ; up>up>bup> ; Mar Domingoup>aup> ; Javier Santesmasesup>aup> ; Maria-Isabel Troyaup>aup> ; Maria Boldó ; up>aup> ; Antoni Bayes-Genisup>aup>up> ; up>up>bup>up> ; up>up>abayesgenis@gmail.com" class="auth_mail" title="E-mail the corresponding authorup>
• 关键词：Heart failure ; Anemia ; Hemoglobin ; Prognosis
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：69
• 期：9
• 页码：820-826
• 全文大小：293 K

文摘

The influence of hemoglobin kinetics on outcomes in heart failure has been incompletely established.

Methods

Hemoglobin was determined at the first visit and at 6 months. Anemia was defined according to World Health Organization criteria (hemoglobin < 13 g/dL for men and hemoglobin < 12 g/dL for women). Patients were classified relative to their hemoglobin values as nonanemic (both measurements normal), transiently anemic (anemic at the first visit but not at 6 months), newly anemic (nonanemic initially but anemic at 6 months), or permanently anemic (anemic in both measurements).

Results

A total of 1173 consecutive patients (71.9% men, mean age 66.8 ± 12.2 years) were included in the study. In all, 476 patients (40.6%) were considered nonanemic, 170 (14.5%) had transient anemia, 147 (12.5%) developed new-onset anemia, and 380 (32.4%) were persistently anemic. During a follow-up of 3.7 ± 2.8 years after the 6-month visit, 494 patients died. On comprehensive multivariable analyses, anemia (P < .001) and the type of anemia (P < .001) remained as independent predictors of all-cause mortality. Compared with patients without anemia, patients with persistent anemia (hazard ratio [HR] = 1.62; 95% confidence interval [95%CI], 1.30-2.03; P < .001) and new-onset anemia (HR = 1.39; 95%CI, 1.04-1.87, P = .03) had higher mortality, and even transient anemia showed a similar trend, although without reaching statistical significance (HR = 1.31; 95%CI, 0.97-1.77, P = .075).

Conclusions

Anemia, especially persistent and of new-onset, and to a lesser degree, transient anemia, is deleterious in heart failure.