PMID- 28623639
OWN - NLM
STAT- MEDLINE
DCOM- 20180417
LR  - 20181202
IS  - 1724-6040 (Electronic)
IS  - 0391-3988 (Linking)
VI  - 40
IP  - 9
DP  - 2017 Sep 15
TI  - Anemia after continuous-flow left ventricular assist device implantation: 
      characteristics and implications.
PG  - 481-488
LID - 10.5301/ijao.5000607 [doi]
AB  - BACKGROUND: Anemia is common in patients with heart failure and is associated 
      with adverse outcomes. Management of anemia in CF-LVAD patients is not well 
      studied. Our purpose is to characterize and identify the etiology of anemia in 
      CF-LVAD patients. Secondary objectives are to describe the effect of CF-LVAD on 
      pre-existing anemia and assess its impact after CF-LVAD support. METHODS: 
      Cross-sectional study from January to July 2015 of ambulatory patients supported 
      with a CF-LVAD for at least 6-months that presented with hemoglobin <12 g/dL and 
      no recent gastrointestinal bleeding. Patients were classified as iron-deficient 
      and non-iron-deficient and compared. Additionally, a retrospective analysis of 
      116 consecutive patients who underwent CF-LVAD from 2008 to 2013 with reported 
      hemoglobin at 6 months as outpatients were divided into anemic or non-anemic and 
      compared. RESULTS: In our cross-sectional cohort, iron deficiency was the most 
      common cause of anemia. Notably, 49% of the iron-deficient patients were already 
      on iron supplementation. In our retrospective cohort, 59% of the patients were 
      anemic after 6 months of support. Anemic patients were older, had lower albumin, 
      higher brain natriuretic peptide (BNP), worse renal function and New York Heart 
      Association (NYHA) class. Anemia had a HR of 3.16 (95%CI 1.38-7.26) to predict a 
      composite of 1-year death and HF readmissions, as well as HF-readmissions alone. 
      CONCLUSIONS: The most common cause of anemia in our study was iron-deficiency; 
      almost half of the patients were iron deficient despite treatment, suggesting 
      that oral iron may not be sufficient to reverse anemia. Anemia regardless of 
      etiology was associated with adverse outcomes.
FAU - Amione-Guerra, Javier
AU  - Amione-Guerra J
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Cruz-Solbes, Ana S
AU  - Cruz-Solbes AS
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Bhimaraj, Arvind
AU  - Bhimaraj A
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Trachtenberg, Barry H
AU  - Trachtenberg BH
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Pingali, Sai R
AU  - Pingali SR
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Estep, Jerry D
AU  - Estep JD
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Park, Myung H
AU  - Park MH
AD  - Houston Methodist Hospital, Houston, TX - USA.
FAU - Guha, Ashrith
AU  - Guha A
AD  - Houston Methodist Hospital, Houston, TX - USA.
LA  - eng
PT  - Journal Article
DEP - 20170614
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
RN  - 0 (Ferrous Compounds)
RN  - 0 (Hematinics)
RN  - 0 (Hemoglobins)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 39R4TAN1VT (ferrous sulfate)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anemia/drug therapy/*epidemiology
MH  - Cross-Sectional Studies
MH  - Female
MH  - Ferrous Compounds/therapeutic use
MH  - Heart Failure/epidemiology/*surgery
MH  - *Heart-Assist Devices
MH  - Hematinics/therapeutic use
MH  - Hemoglobins/analysis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/analysis
MH  - Retrospective Studies
EDAT- 2017/06/18 06:00
MHDA- 2018/04/18 06:00
CRDT- 2017/06/18 06:00
PHST- 2017/05/11 00:00 [accepted]
PHST- 2017/06/18 06:00 [pubmed]
PHST- 2018/04/18 06:00 [medline]
PHST- 2017/06/18 06:00 [entrez]
AID - 6A0E6473-5BB4-4E26-8FE5-08A7AA455588 [pii]
AID - 10.5301/ijao.5000607 [doi]
PST - ppublish
SO  - Int J Artif Organs. 2017 Sep 15;40(9):481-488. doi: 10.5301/ijao.5000607. Epub 
      2017 Jun 14.