PMID- 12957766
OWN - NLM
STAT- MEDLINE
DCOM- 20031209
LR  - 20220330
IS  - 0167-5273 (Print)
IS  - 0167-5273 (Linking)
VI  - 90
IP  - 2-3
DP  - 2003 Aug
TI  - Anaemia is an independent predictor of poor outcome in patients with chronic 
      heart failure.
PG  - 303-8
AB  - BACKGROUND: Mild anaemia frequently occurs in patients with chronic heart failure 
      (CHF), particularly in the advanced stages of the disease. The correction of 
      anaemia with erythropoietin is a therapeutic possibility. The aim of this study 
      was to assess prospectively the relationship between the prevalence of anaemia 
      (haemoglobin level<or=120 g/l) and prognosis in an unselected CHF population. 
      METHODS: All consecutive patients with a diagnosis of CHF admitted to our 
      department between January 2000 and April 2000 were considered for the present 
      study. Those with secondary causes of anaemia were excluded. Patients were 
      followed up until November 2001 (>18 months in all survivors), and the end-point 
      of the study was all-cause mortality. RESULTS: A total of 176 patients were 
      enrolled (mean age: 63 years, New York Heart Association (NYHA) classification 
      I/II/III/IV: 15/81/51/29; left ventricular ejection fraction (LVEF): 42%, 
      ischaemic aetiology in 62%). In the whole population the mean haemoglobin level 
      was 140+/-15 g/l. Anaemia was found in 18 (10%) patients, and was significantly 
      more common in women than in men (18 vs. 7%, respectively, P=0.02) and in those 
      with most severe CHF symptoms (frequency in NYHA I/II/III/IV: 0/9/10/21%, 
      respectively; NYHA IV vs. I-III, P=0.03), but not related to the other clinical 
      indices. Univariate analysis revealed NYHA class III-IV (hazard ratio 3.8, 95% 
      CI: 1.6-8.9, P=0.003), low LVEF <35% (hazard ratio 2.3, 95% CI: 1.0-4.9, P=0.04) 
      and anaemia (hazard ratio 2.9, 95% CI: 1.2-7.2, P=0.02) as predictors of 18-month 
      mortality. In multivariate analysis, anaemia remained an independent predictor of 
      death when adjusted for NYHA class and LVEF (hazard ratio: 2.6, 95% CI: 1.0-6.5, 
      P=0.04). In anaemic patients, 18-month survival was 67% (95% CI: 45-89%) compared 
      to 87% (81-92%) in patients with a normal haemoglobin level (P=0.016). 
      CONCLUSIONS: Mild anaemia is a significant and independent predictor of poor 
      outcome in unselected patients with CHF. Correction of low haemoglobin level may 
      become an interesting therapeutic option for CHF patients.
FAU - Szachniewicz, J
AU  - Szachniewicz J
AD  - Department of Cardiology, Military Hospital, ul Weigla 5, 50-891 Wroclaw, Poland.
FAU - Petruk-Kowalczyk, J
AU  - Petruk-Kowalczyk J
FAU - Majda, J
AU  - Majda J
FAU - Kaczmarek, A
AU  - Kaczmarek A
FAU - Reczuch, K
AU  - Reczuch K
FAU - Kalra, P R
AU  - Kalra PR
FAU - Piepoli, M F
AU  - Piepoli MF
FAU - Anker, S D
AU  - Anker SD
FAU - Banasiak, W
AU  - Banasiak W
FAU - Ponikowski, P
AU  - Ponikowski P
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Analysis of Variance
MH  - Anemia/epidemiology/*etiology
MH  - Female
MH  - Heart Failure/*complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Statistics, Nonparametric
EDAT- 2003/09/06 05:00
MHDA- 2003/12/11 05:00
CRDT- 2003/09/06 05:00
PHST- 2003/09/06 05:00 [pubmed]
PHST- 2003/12/11 05:00 [medline]
PHST- 2003/09/06 05:00 [entrez]
AID - S0167527302005740 [pii]
AID - 10.1016/s0167-5273(02)00574-0 [doi]
PST - ppublish
SO  - Int J Cardiol. 2003 Aug;90(2-3):303-8. doi: 10.1016/s0167-5273(02)00574-0.