Anaemia is an independent predictor of poor outcome in patients with chronic heart failure

Szachniewicz, Joanna; Petruk-Kowalczyk, Jolanta; Majda, Jacek; Kaczmarek, Agnieszka; Reczuch, Krzysztof; Kalra, Paul R.; Piepoli, Massimo F; Anker, Stefan D.; Banasiak, Waldemar; Ponikowski, Piotr

doi:10.1016/s0167-5273(02)00574-0

Cited by 126 publications

(66 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The presence of anemia is associated with increased severity of HF [2,3], and higher rates of rehospitalization [4], and mortality [2][3][4][5][6]. Despite the evidence, however, the role of anemia as a risk factor has not yet been included in the American College of Cardiology, American Heart Association, or European Society of Cardiology guidelines on the assessment and management of heart failure patients [7,8].…”

Section: Introductionmentioning

confidence: 99%

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Omland

Knudsen

et al. 2005

American J Hematol

View full text Add to dashboard Cite

While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), it is not in defined guidelines for HF assessment. B-type natriuretic peptide (BNP) is a marker for diagnosis and management of patients with HF. We determined the incidence of anemia in patients with HF and the relationship between BNP and hemoglobin (Hgb) levels in patients with and without HF. Results from the Breathing Not Properly Multinational Trial consisted of 1586 patients presenting to the emergency department (ED) with dyspnea. Because renal insufficiency is a confounding variable for BNP, patients with a creatinine of ‡2.0 mg/dL were excluded. The remaining data were evaluated from 620 non-HF patients (337 M, 283 F) and 547 HF patients (299 M, 248 F). The New York Heart Association (NYHA) HF classification and ejection fraction by echocardiography were assessed for HF patients. Blood was tested for Hgb, BNP, and creatinine. Using World Health Organization criteria for anemia, we observed that HF patients in NYHA class III or IV had lower mean Hgb levels (12.5 g/dL, P < 0.05) and a higher incidence of anemia (48.2%, P < 0.05) than did HF patients in class I or II (13.4 g/dL and 33.9%, respectively). There was no correlation between Hgb and log BNP for females without HF or the aggregate of all HF patients. In contrast, a significant inverse correlation was observed for males without HF (P < 0.001). Although there were differences in the BMI, age, and estimated glomerular filtration rate (eGFR) versus Hgb observed in this group, the log BNP correlation remained significant after multivariate analysis. A significant inverse correlation for log BNP and Hgb were also observed for diastolic (EF ‡ 50) HF (P < 0.05) that was also not accounted for by the BMI, age, or eGFR. The presence of anemia is associated with worsening HF at ED presentation. For males without HF and diastolic HF patients of both genders, a low Hgb may be a confounding variable toward

show abstract

Section: Introductionmentioning

confidence: 99%

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Omland

Knudsen

et al. 2005

American J Hematol

View full text Add to dashboard Cite

show abstract

“…Several studies suggest that anemia may be associated with poorer health status and increased adverse outcomes from CHF. [1][2][3][4][5][6][7][8] Some other studies, however, did not find anemia to have a significant impact on the prognosis of CHF, and reduced hemoglobin (Hb) levels are not independently associated with shorter survival. [9][10][11][12][13] Moreover, whether changes in Hb over time are also related to the risk of morbid events or mortality is not clear.…”

mentioning

confidence: 99%

The Impact of Anemia on the Prognosis of Chronic Heart Failure: A Meta‐Analysis and Systemic Review

Wang

2009

Congestive Heart Failure

View full text Add to dashboard Cite

The aim of this study was to assess the impact of anemia on the clinical outcomes of chronic heart failure (CHF) by a meta‐analysis and systemic review of published literatures. Twenty published English‐language articles were selected from Medline, PubMed, and ISI Database. Clinical data were extracted, pooled, and analyzed with a fixed‐ or random‐effects model. A total of 97,699 patients with CHF were identified from the published studies. Meta‐analysis of these studies indicated that anemia is associated with a higher risk for death (relative risk [RR], 1.66; P<.0001). In addition, anemic patients had more advanced New York Heart Association class (III or IV; RR, 1.35; P<.0001) and lower left ventricular ejection fraction (weight mean difference, −0.53; P<.0001) than nonanemic patients. Systemic review also revealed that the severity of anemia is closely related to the rate of mortality and hospitalization for heart failure. Anemia is associated with an increased risk of mortality and rate of hospitalization for heart failure. Anemia is an independent risk factor for adverse outcomes in patients with CHF.

show abstract

“…[2][3][4] Recent studies have demonstrated that anemia is highly prevalent in patients who have heart failure and is strongly associated with systolic dysfunction. 2,3,[5][6][7][8] However, ≤ 50% of patients who have heart failure have preserved systolic function, 9-12 and the association of anemia with diastolic dysfunction in this population has not been studied. We conducted a cross-sectional study to assess the associations of anemia with diastolic dysfunction and left ventricular hypertrophy (LVH) in 822 outpatients who had known coronary artery disease with preserved systolic function.…”

mentioning

confidence: 99%

Association of anemia with diastolic dysfunction among patients with coronary artery disease in the Heart and Soul Study

Nair¹,

Shlipak

Angeja

et al. 2005

The American Journal of Cardiology

View full text Add to dashboard Cite

We performed a cross-sectional study to evaluate the association of anemia with diastolic dysfunction and left ventricular hypertrophy (LVH) in outpatients who had coronary artery disease. Logistic regression was used to examine the association of blood hemoglobin (Hb) concentrations with diastolic dysfunction and LVH in 822 participants in the Heart and Soul Study who had normal sinus rhythm and preserved systolic function (left ventricular ejection fraction ≥50%). Using transthoracic echocardiography, diastolic dysfunction was defined as diastolically dominant pulmonary vein flow, and LVH was defined as left ventricular mass index >90 g/m 2 . Anemia (Hb <13 g/dl) was present in 24% of participants (197 of 822). The prevalence of diastolic dysfunction ranged from 8% in participants who did not have anemia (Hb ≥13 g/dl) to 13% in those who had moderate anemia (Hb 11 to 13 g/dl) to 24% in those who had severe anemia (Hb < 11 g/dl, p = 0.004 for trend). After multivariable adjustment, moderate anemia (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.1 to 3.6) and severe anemia (OR 6.6, 95% CI 1.9 to 24.9) remained strongly associated with diastolic dysfunction. In contrast, moderate anemia (OR 1.4, 95% CI 1.0 to 2.1) and severe anemia (OR 1.6, 95% CI 0.6 to 4.6) were not significantly associated with LVH. We found anemia to be strongly associated with diastolic dysfunction but not with LVH in this community-based sample of outpatients who had established coronary disease.The presence of anemia is associated with adverse outcomes in many conditions, including end-stage renal disease 1 and myocardial ischemia, but its relation to heart failure has only recently been appreciated. [2][3][4] Recent studies have demonstrated that anemia is highly prevalent in patients who have heart failure and is strongly associated with systolic dysfunction. 2,3,[5][6][7][8] However, ≤ 50% of patients who have heart failure have preserved systolic function, 9-12 and the association of anemia with diastolic dysfunction in this population has not been studied. We conducted a cross-sectional study to assess the associations of anemia with diastolic dysfunction and left ventricular hypertrophy (LVH) in 822 outpatients who had known coronary artery disease with preserved systolic function. METHODS Study participantsThe Heart and Soul Study is investigating the influence of psychosocial factors on cardiovascular outcomes in patients who have coronary artery disease. Methods have been described previously. 13 In brief, we used administrative databases to identify outpatients who NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript had documented coronary artery disease at 2 Department of Veterans Affairs Medical Centers (San Francisco and Palo Alto, California), 1 university-based medical center (University of California, San Francisco), and 9 public health clinics in the Community Health Network of San Francisco. Patients were eligible to participate if they had ≥1 of the following: myocardial infarction, c...

show abstract

Anaemia is an independent predictor of poor outcome in patients with chronic heart failure

Cited by 126 publications

References 22 publications

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

The Impact of Anemia on the Prognosis of Chronic Heart Failure: A Meta‐Analysis and Systemic Review

Association of anemia with diastolic dysfunction among patients with coronary artery disease in the Heart and Soul Study

Contact Info

Product

Resources

About