PMID- 26897638
OWN - NLM
STAT- MEDLINE
DCOM- 20160809
LR  - 20181113
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 117
IP  - 8
DP  - 2016 Apr 15
TI  - Usefulness of Relative Hypochromia in Risk Stratification for Nonanemic Patients 
      With Chronic Heart Failure.
PG  - 1299-304
LID - S0002-9149(16)30145-X [pii]
LID - 10.1016/j.amjcard.2016.01.023 [doi]
AB  - The purpose of this study is to investigate the impact of a reduction of 
      hemoglobin (Hb) content in the erythrocytes as estimated by mean corpuscular 
      hemoglobin concentration (MCHC) on long-term clinical outcomes in nonanemic 
      patients with heart failure (HF). We prospectively enrolled 1,579 subjects with 
      HF who underwent coronary angiography enrolled in the GeneBank study with 5-year 
      follow-up of all-cause mortality. Levels of Hb and MCHC were assessed at 
      enrollment and after 6 months of follow-up. Anemia was defined as Hb levels 
      <13 g/dl in men and <12 g/dl in women. In our nonanemic cohort (n = 785, 49.7%), 
      mean Hb and median MCHC were 13.8 +/- 1.1 g/dl and 34.3 g/dL (interquartile range 
      33.6 to 35), respectively. Nonanemic patients with heart failure with lower MCHC 
      had higher mortality risk (quartiles 1 vs 4, hazard ratio = 2.1, 95% confidence 
      interval 1.4 to 3.3, p = 0.001). In a subset of nonanemic patients with 
      persistent normal Hb on follow-up (n = 206), the mean time between baseline and 
      follow-up MCHC levels was 169.3 +/- 41.6 days. In comparison with patients with 
      levels of MCHC more than the first quartile (>/=33.6 g/dl) on baseline and 
      follow-up, patients with persistently low MCHC (<33.6 g/dl) had a significantly 
      increased mortality risk (log rank <0.001). All models remained significant even 
      after adjusting for traditional cardiac risk factors, left ventricular ejection 
      fraction, baseline Hb levels, and mean corpuscular volume. In conclusion, 
      relative hypochromia is an independent predictor of increased mortality risk in 
      patients with HF, even in the setting of normal Hb levels.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Hammadah, Muhammad
AU  - Hammadah M
AD  - Division of Cardiology, Department of Medicine, Emory University, Atlanta, 
      Georgia.
FAU - Brennan, Marie-Luise
AU  - Brennan ML
AD  - Epinomics, Menlo Park, California.
FAU - Wu, Yuping
AU  - Wu Y
AD  - Department of Mathematics, Cleveland State University, Cleveland, Ohio.
FAU - Hazen, Stanley L
AU  - Hazen SL
AD  - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, Ohio; Department of Cellular and Molecular Medicine, Lerner 
      Research Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Tang, W H Wilson
AU  - Tang WH
AD  - Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, Ohio; Department of Cellular and Molecular Medicine, Lerner 
      Research Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: 
      tangw@ccf.org.
LA  - eng
GR  - R01HL103866/HL/NHLBI NIH HHS/United States
GR  - R01 HL103931/HL/NHLBI NIH HHS/United States
GR  - R01 HL103866/HL/NHLBI NIH HHS/United States
GR  - P01 HL076491/HL/NHLBI NIH HHS/United States
GR  - P20HL113452/HL/NHLBI NIH HHS/United States
GR  - P20 HL113452/HL/NHLBI NIH HHS/United States
GR  - P01HL098055/HL/NHLBI NIH HHS/United States
GR  - R01HL103931/HL/NHLBI NIH HHS/United States
GR  - P01 HL098055/HL/NHLBI NIH HHS/United States
GR  - P01HL076491/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000439/TR/NCATS NIH HHS/United States
GR  - UL1TR000439/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20160128
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Anemia, Hypochromic/*blood/epidemiology/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/blood/complications/*epidemiology
MH  - Hemoglobins/*metabolism
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Morbidity/trends
MH  - Ohio/epidemiology
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Time Factors
PMC - PMC4811711
MID - NIHMS755467
EDAT- 2016/02/22 06:00
MHDA- 2016/08/10 06:00
PMCR- 2017/04/15
CRDT- 2016/02/22 06:00
PHST- 2015/09/14 00:00 [received]
PHST- 2016/01/22 00:00 [revised]
PHST- 2016/01/22 00:00 [accepted]
PHST- 2016/02/22 06:00 [entrez]
PHST- 2016/02/22 06:00 [pubmed]
PHST- 2016/08/10 06:00 [medline]
PHST- 2017/04/15 00:00 [pmc-release]
AID - S0002-9149(16)30145-X [pii]
AID - 10.1016/j.amjcard.2016.01.023 [doi]
PST - ppublish
SO  - Am J Cardiol. 2016 Apr 15;117(8):1299-304. doi: 10.1016/j.amjcard.2016.01.023. 
      Epub 2016 Jan 28.