PMID- 12039491
OWN - NLM
STAT- MEDLINE
DCOM- 20020614
LR  - 20220311
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 39
IP  - 11
DP  - 2002 Jun 5
TI  - Anemia is associated with worse symptoms, greater impairment in functional 
      capacity and a significant increase in mortality in patients with advanced heart 
      failure.
PG  - 1780-6
AB  - OBJECTIVES: This study aimed to evaluate the relationship between anemia and 
      heart failure (HF) prognosis. BACKGROUND: Although it is known that chronic 
      diseases, including HF, may be associated with anemia, the impact of hemoglobin 
      (Hb) level on symptoms and survival in HF has not been fully defined. We analyzed 
      a cohort of 1,061 patients with advanced HF (New York Heart Association [NYHA] 
      functional class III or IV and left ventricular ejection fraction [LVEF] <40%) 
      referred to a single center for evaluation and management. The Hb level was drawn 
      at time of initial evaluation. Patients were divided into quartiles of Hb: Hb 
      <12.3; Hb 12.3 to 13.6; Hb 13.7 to 14.8; Hb >14.8 g/dl. RESULTS: Mean Hb was 
      13.6, and values ranged from 7.1 to 19.0 g/dl. The Hb groups were similar in age, 
      medication profile, LVEF, hypertension, diabetes, smoking status and serum 
      sodium. Lower Hb was associated with an impaired hemodynamic profile, higher 
      blood urea nitrogen and creatinine, and lower albumin, total cholesterol and body 
      mass index. Patients in the lower Hb quartiles were more likely to be NYHA 
      functional class IV (p < 0.0001) and have lower peak oxygen consumption (PKVO(2)) 
      (p < 0.0001). Survival at one year was higher with increased Hb quartile (55.6%, 
      63.9%, 71.4% and 74.4% for quartiles 1, 2, 3 and 4, respectively). On 
      multivariate analysis adjusting for known HF prognostic factors, low Hb proved to 
      be an independent predictor of mortality (relative risk 1.131, confidence 
      interval 1.045 to 1.224 for each decrease of 1 g/dl). CONCLUSIONS: In chronic HF, 
      relatively mild degrees of anemia are associated with worsened symptoms, 
      functional status and survival.
FAU - Horwich, Tamara B
AU  - Horwich TB
AD  - Department of Medicine, Division of Cardiology, University of California-Los 
      Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1679, USA.
FAU - Fonarow, Gregg C
AU  - Fonarow GC
FAU - Hamilton, Michele A
AU  - Hamilton MA
FAU - MacLellan, W Robb
AU  - MacLellan WR
FAU - Borenstein, Jeff
AU  - Borenstein J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Hemoglobins)
SB  - IM
CIN - J Am Coll Cardiol. 2002 Dec 18;40(12):2204; author reply 2204. PMID: 12505236
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anemia/*complications
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure/blood/*complications/mortality/physiopathology
MH  - Hematocrit
MH  - Hemoglobins/analysis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nutrition Disorders/complications
MH  - Survival Analysis
EDAT- 2002/06/01 10:00
MHDA- 2002/06/18 10:01
CRDT- 2002/06/01 10:00
PHST- 2002/06/01 10:00 [pubmed]
PHST- 2002/06/18 10:01 [medline]
PHST- 2002/06/01 10:00 [entrez]
AID - S0735109702018545 [pii]
AID - 10.1016/s0735-1097(02)01854-5 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Jun 5;39(11):1780-6. doi: 10.1016/s0735-1097(02)01854-5.