Prognostic Impact of Anemia in Patients With Chronic Heart Failure　– With Special Reference to Clinical Background: Report From the CHART-2 Study –

Yamauchi, Takeshi; Sakata, Yasuhiko; Takada, Tsuyoshi; Nochioka, Kotaro; Miura, Masanobu; Tadaki, Soichiro; Ushigome, Ryoichi; Sato, Kenjiro; Onose, Takeo; Tsuji, Kiichiro; Abe, Ruri; Takahashi, Jun; Miyata, Satoshi; Shimokawa, Hiroaki

doi:10.1253/circj.cj-15-0174

Cited by 36 publications

(21 citation statements)

References 26 publications

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“…No clear explanation for the difference in prevalence of COPD among these studies have been given, whereas CKD prevalence may differ among these studies due to lack of a standard definition of CKD. Anaemia as defined by the World Health Organization criteria was observed in 35% in CHART‐2, 58% in ATTEND, 57% in JCARE‐CARD, whereas 51% for women and 56% for men in ADHERE, and 37% for younger (< 80) and 47% for older patients (> = 80) in EHFS II …”

Section: Ageing and Heart Failure—heart Failure With Preserved Ejectimentioning

confidence: 99%

Heart failure epidemiology and novel treatments in Japan: facts and numbers

et al. 2016

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Japan has the highest proportion of older people in the world, 25.9% of the population were aged 65 or above in 2014. Although there have been no population‐based studies that precisely examined the prevalence of heart failure in Japan, one report estimated the number of Japanese outpatients with left ventricular dysfunction was 979, 000 (0.8% of total population), which was projected to increase gradually as the population ages, reaching 1.3 million by 2030. Ischemic etiology was less frequently observed in Japan (31–47%) than in western population (54–57%). The prevalence of HF with preserved ejection fraction was similar between Japan (34–68%) and western countries (34–51%). Non‐cardiac co‐morbidities such as chronic obstructive pulmonary diseases and anemia were observed in 6–9% in Japan and 19–31% in western countries, and 35–58% in Japan and 37–56% in western countries, respectively. The definition of chronic kidney disease widely differed among studies. A relatively good survival prognosis in Japanese patients has been discussed. One‐year mortality after discharge from initial hospitalization was 9–12%, which seems to be better than the western cohort. Although length of stay was remarkably longer in Japan (15–21 days) than western countries (4–9 days), it will have to be shortened, as Japan is now being faced with an upcoming HF pandemic. Some treatments in Japan are not approved outside Japan. Such treatments include carperitide infusion (used in 58% of hospitalized HF), nicorandil infusion (9.6%), and oral pimobendan (5%). More recently, landiolol and tolvaptan have been approved. Although these drugs might have a potential to be an effective therapeutic option, lack of corroborating evidence in many of such treatments would emphasize the need for larger clinical trials.

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Section: Ageing and Heart Failure—heart Failure With Preserved Ejectimentioning

confidence: 99%

Heart failure epidemiology and novel treatments in Japan: facts and numbers

et al. 2016

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“…The prevalence of anemia in a broad range of studies (6–70%) (Table reflects heterogeneity in anemia screening; the clinical setting(hospitalized vs. out‐patients); and the socio‐economic status of study populations. Up to 2/3 of patients have contributing factors, such as CKD and/or anemia of inflammation .…”

Section: Prevalence Of Anemiamentioning

confidence: 99%

Management of anemia in patients with congestive heart failure

Goodnough

Comín‐Colet

Leal-Noval³

et al. 2016

American J Hematol

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Anemia is an independent risk factor for adverse patient outcomes. There are no guidelines for management of anemia in patients with congestive heart failure (CHF), despite its high incidence. Four objectives were defined by the International Anemia Management and Clinical Outcomes Expert Panel (AMCO), a multinational group of interdisciplinary experts identified by the Society for the Advancement of Blood Management (SABM) to: determine the prevalence of anemia in outpatients; to determine the prevalence of hospital‐acquired anemia; to assess the impact of anemia management on clinical outcomes such as quality of life and functional status; and to provide recommendations for primary care physicians and specialists for the diagnosis, evaluation, and management of anemia in patients with CHF. Anemia and iron deficiency were confirmed to be highly prevalent in patients with CHF. Intravenous iron therapy improves anemia, cardiac function and exercise tolerance, leading to improvement in quality of life. Anemia management has been demonstrated to be cost‐effective. Clinical care pathways to manage anemia in patients with CHF are recommended as best practices in order to improve patient outcomes. Am. J. Hematol. 92:88–93, 2017. © 2016 Wiley Periodicals, Inc.

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“…1- 3 The mechanisms by which anemia worsens HF outcomes are unclear but may be related to increased myocardial workload. 4 In chronic severe anemia, a low hemoglobin (Hb) concentration reduces systemic vascular resistance (SVR) as the result of decreases in blood viscosity and enhanced nitric oxide-mediated vasodilation.…”

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confidence: 99%

Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

Tanimura

Dohi

Fujimoto

et al. 2017

Circ J

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Background:We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients. Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=−0.34 and 0.42, P<0.05, respectively), and was the strongest contributor of SVRI only in the HC group. Anemic patients more frequently required intravenous inotropic support despite having higher CI and lower SVRI than non-anemic patients in the HC group. The novel hemodynamic subsets based on mean right atrial pressure and estimated left ventricular stroke work index but not Forrester subsets appropriately predicted the need for intravenous inotropic support. The probability of hospitalization for worsening HF during 2-year follow-up period was significantly higher in anemic patients than in nonanemic patients in the HC group.Conclusions: Anemia had a direct effect on cardiovascular hemodynamics and thus can confound therapeutic planning in HF patients with HC. The novel hemodynamic subsets can be applied in daily clinical practice regardless of the presence or absence of anemia.

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Prognostic Impact of Anemia in Patients With Chronic Heart Failure　– With Special Reference to Clinical Background: Report From the CHART-2 Study –

Cited by 36 publications

References 26 publications

Heart failure epidemiology and novel treatments in Japan: facts and numbers

Heart failure epidemiology and novel treatments in Japan: facts and numbers

Management of anemia in patients with congestive heart failure

Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

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Prognostic Impact of Anemia in Patients With Chronic Heart Failure – With Special Reference to Clinical Background: Report From the CHART-2 Study –

Cited by 36 publications

References 26 publications

Heart failure epidemiology and novel treatments in Japan: facts and numbers

Heart failure epidemiology and novel treatments in Japan: facts and numbers

Management of anemia in patients with congestive heart failure

Effect of Anemia on Cardiovascular Hemodynamics, Therapeutic Strategy and Clinical Outcomes in Patients With Heart Failure and Hemodynamic Congestion

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Prognostic Impact of Anemia in Patients With Chronic Heart Failure　– With Special Reference to Clinical Background: Report From the CHART-2 Study –