BACKGROUND: Hemoglobin and amino-terminal pro-brain natriuretic peptide (NT-proBNP) are both independent predictors of mortality in patients with chronic HF. Their combined predictive power for mortality in the setting of acute HF is uncertain. METHODS: In an international prospective cohort design, we evaluated the relationships between hemoglobin, NT-proBNP, and 60-day mortality in 690 patients with acute HF. RESULTS: The median hemoglobin for the entire cohort was 13.0 g/dL (interquartile range 11.6-14.3). The WHO criterion for anemia was met by 44% (n=305). The 60-day mortality rate for anemic patients was 16.4% vs. 8.8% in non-anemic patients (p<0.001). Anemia was an independent predictor of short-term mortality (OR=1.72, 95% CI=1.05-2.80, p=0.03), as was a NT-proBNP concentration >5180 pg/mL (OR=2.32, 95% CI=1.36-3.94 p=0.002). Consideration of four risk groups: not anemic/low NT-proBNP (reference group, n=220), anemic/low NT-proBNP (n=152), not anemic/high NT-proBNP (n=165), and anemic/high NT-proBNP (n=153) revealed respective 60-day mortality rates of 5.0% (referent), 9.2% (OR=1.93, 95% CI=0.85-4.36; p=0.12), 13.9% (OR=3.07, 95% CI=1.45-6.50, p=0.003), and 23.5% (OR=5.84, 95% CI=2.87-11.89, p<0.001). CONCLUSIONS: Anemia was common in this cohort of subjects with acute HF and was related to adverse short-term outcome. Integrated use of hemoglobin and NT-proBNP measurements provides powerful additive information and is superior to the use of either in isolation.
BACKGROUND: Hemoglobin and amino-terminal pro-brain natriuretic peptide (NT-proBNP) are both independent predictors of mortality in patients with chronic HF. Their combined predictive power for mortality in the setting of acute HF is uncertain. METHODS: In an international prospective cohort design, we evaluated the relationships between hemoglobin, NT-proBNP, and 60-day mortality in 690 patients with acute HF. RESULTS: The median hemoglobin for the entire cohort was 13.0 g/dL (interquartile range 11.6-14.3). The WHO criterion for anemia was met by 44% (n=305). The 60-day mortality rate for anemicpatients was 16.4% vs. 8.8% in non-anemicpatients (p<0.001). Anemia was an independent predictor of short-term mortality (OR=1.72, 95% CI=1.05-2.80, p=0.03), as was a NT-proBNP concentration >5180 pg/mL (OR=2.32, 95% CI=1.36-3.94 p=0.002). Consideration of four risk groups: not anemic/low NT-proBNP (reference group, n=220), anemic/low NT-proBNP (n=152), not anemic/high NT-proBNP (n=165), and anemic/high NT-proBNP (n=153) revealed respective 60-day mortality rates of 5.0% (referent), 9.2% (OR=1.93, 95% CI=0.85-4.36; p=0.12), 13.9% (OR=3.07, 95% CI=1.45-6.50, p=0.003), and 23.5% (OR=5.84, 95% CI=2.87-11.89, p<0.001). CONCLUSIONS:Anemia was common in this cohort of subjects with acute HF and was related to adverse short-term outcome. Integrated use of hemoglobin and NT-proBNP measurements provides powerful additive information and is superior to the use of either in isolation.
Authors: Pasqualina L Santaguida; Andrew C Don-Wauchope; Mark Oremus; Robert McKelvie; Usman Ali; Stephen A Hill; Cynthia Balion; Ronald A Booth; Judy A Brown; Amy Bustamam; Nazmul Sohel; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Luigi Tarantini; Fabrizio Oliva; Silvia Cantoni; Giovanni Cioffi; Virginia Agnoletto; Gianfranco Alunni; Francesca De Cian; Andrea Di Lenarda; Donata Lucci; Giovanni Pulignano; Laura Scelsi; Aldo Pietro Maggioni; Luigi Tavazzi Journal: Intern Emerg Med Date: 2011-05-05 Impact factor: 3.397
Authors: Mazhar A Afaq; Azadeh Shoraki; Oleg Ivanov; Janardhan Srinivasan; Lawrence Bernstein; Stuart W Zarich Journal: J Clin Med Res Date: 2011-07-26