TY - JOUR
T1 - Hemoglobin Kinetics and Long-term Prognosis in Heart Failure
AU - Díez-López, Carles
AU - Lupón, Josep
AU - de Antonio, Marta
AU - Zamora, Elisabet
AU - Domingo, Mar
AU - Santesmases, Javier
AU - Troya, Maria Isabel
AU - Boldó, Maria
AU - Bayes-Genis, Antoni
PY - 2016/9/1
Y1 - 2016/9/1
N2 - © 2016 Sociedad Española de Cardiología Introduction and objectives 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. Full English text available from: www.revespcardiol.org/en
AB - © 2016 Sociedad Española de Cardiología Introduction and objectives 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. Full English text available from: www.revespcardiol.org/en
KW - Anemia
KW - Heart failure
KW - Hemoglobin
KW - Prognosis
U2 - 10.1016/j.recesp.2016.02.033
DO - 10.1016/j.recesp.2016.02.033
M3 - Article
VL - 69
SP - 820
EP - 826
IS - 9
ER -