PMID- 16247751
OWN - NLM
STAT- MEDLINE
DCOM- 20060112
LR  - 20071115
IS  - 0361-8609 (Print)
IS  - 0361-8609 (Linking)
VI  - 80
IP  - 3
DP  - 2005 Nov
TI  - 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.
PG  - 174-80
AB  - 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 
      1,586 patients presenting to the emergency department (ED) with dyspnea. Because 
      renal insufficiency is a confounding variable for BNP, patients with a creatinine 
      of >or=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 >or= 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 increasing BNP. Among systolic HF patients, the presence of a low 
      hemoglobin concentration is not a factor in the interpretation of BNP results.
FAU - Wu, Alan H B
AU  - Wu AH
AD  - Department of Laboratory Medicine, University of California, San Francisco, San 
      Francisco General Hospital, 1001 Potrero Ave., California 94110, USA. 
      wualan@labmed2.ucsf.edu
FAU - Omland, Torbjorn
AU  - Omland T
FAU - Wold Knudsen, Cathrine
AU  - Wold Knudsen C
FAU - McCord, James
AU  - McCord J
FAU - Nowak, Richard M
AU  - Nowak RM
FAU - Hollander, Judd E
AU  - Hollander JE
FAU - Duc, Philippe
AU  - Duc P
FAU - Storrow, Alan B
AU  - Storrow AB
FAU - Abraham, William T
AU  - Abraham WT
FAU - Clopton, Paul
AU  - Clopton P
FAU - Maisel, Alan S
AU  - Maisel AS
FAU - McCullough, Peter A
AU  - McCullough PA
CN  - Breathing Not Properly Multinational Study Investigations
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
RN  - 0 (Hemoglobins)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Anemia/blood/*epidemiology
MH  - Case-Control Studies
MH  - Diastole
MH  - Dyspnea/etiology
MH  - Electrocardiography
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Heart Failure/blood/*epidemiology
MH  - Hemoglobins/analysis
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Natriuretic Peptide, Brain/*blood
MH  - Sex Factors
MH  - Systole
EDAT- 2005/10/26 09:00
MHDA- 2006/01/13 09:00
CRDT- 2005/10/26 09:00
PHST- 2005/10/26 09:00 [pubmed]
PHST- 2006/01/13 09:00 [medline]
PHST- 2005/10/26 09:00 [entrez]
AID - 10.1002/ajh.20456 [doi]
PST - ppublish
SO  - Am J Hematol. 2005 Nov;80(3):174-80. doi: 10.1002/ajh.20456.