PMID- 15191772
OWN - NLM
STAT- MEDLINE
DCOM- 20041025
LR  - 20220310
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 25
IP  - 12
DP  - 2004 Jun
TI  - Haemoglobin predicts survival in patients with chronic heart failure: a substudy 
      of the ELITE II trial.
PG  - 1021-8
AB  - AIMS: The correction of anaemia in chronic heart failure (CHF) has been suggested 
      to be associated with an improvement in symptoms and cardiac function. We aimed 
      to investigate the relationship between the concentration of haemoglobin and 
      survival in CHF. METHODS AND RESULTS: We analysed haemoglobin concentrations in 
      3044 patients recruited in the Evaluation of Losartan In The Elderly (ELITE II) 
      trial. Patients of mean age 71.5 +/- 6.8 years (+/-SD) and New York Heart 
      Association (NYHA) class 2.5 +/- 0.6 were enrolled from June 1997 to May 1998 and 
      followed-up for survival (range 1-780 days, median 551). In univariate analysis, 
      age, NYHA class, serum creatinine, left ventricular ejection fraction (all 
      P<0.0001) and sex (P=0.046) all predicted survival. Haemoglobin as a continuous 
      variable for all patients was not a significant prognostic marker (P=0.26). 
      However, sub-dividing patients according to 1.0 g/dL increments of haemoglobin 
      revealed that the survival relationship was non-linear. The results from the 
      polynomial regression suggest that the optimal interval is a symmetric one 
      centred around 14.5 g/dL. This was independent of age, sex, NYHA class, left 
      ventricular ejection fraction, creatinine, co-existing chronic obstructive 
      pulmonary disease and treatment allocation (P<0.001). There was a minor fall in 
      plasma haemoglobin at the 12-month follow-up (mean change for all patients 0.3 
      +/- 2.2 g/dL, P<0.0001), with no difference between captopril and losartan groups 
      (P>0.3). CONCLUSION: Haemoglobin is an independent predictor of mortality in CHF 
      patients, with anaemic and polycythaemic patients having the worst survival.
FAU - Sharma, Rakesh
AU  - Sharma R
AD  - Department of Clinical Cardiology, National Heart and Lung Institute, Imperial 
      College School of Medicine, London SW3 6LY, UK.
FAU - Francis, Darrel P
AU  - Francis DP
FAU - Pitt, Bertram
AU  - Pitt B
FAU - Poole-Wilson, Philip A
AU  - Poole-Wilson PA
FAU - Coats, Andrew J S
AU  - Coats AJ
FAU - Anker, Stefan D
AU  - Anker SD
LA  - eng
PT  - Clinical Trial
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Diuretics)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Hemoglobins)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - Analysis of Variance
MH  - Aspirin/therapeutic use
MH  - Diuretics/therapeutic use
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Heart Failure/*blood/drug therapy/mortality
MH  - Hemoglobins/*analysis
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Proportional Hazards Models
MH  - Survival Analysis
MH  - Survival Rate
EDAT- 2004/06/12 05:00
MHDA- 2004/10/27 09:00
CRDT- 2004/06/12 05:00
PHST- 2003/02/18 00:00 [received]
PHST- 2004/03/02 00:00 [revised]
PHST- 2004/04/02 00:00 [accepted]
PHST- 2004/06/12 05:00 [pubmed]
PHST- 2004/10/27 09:00 [medline]
PHST- 2004/06/12 05:00 [entrez]
AID - S0195668X04002672 [pii]
AID - 10.1016/j.ehj.2004.04.023 [doi]
PST - ppublish
SO  - Eur Heart J. 2004 Jun;25(12):1021-8. doi: 10.1016/j.ehj.2004.04.023.