AIMS: Anaemia in heart failure (HF) is associated with a poor prognosis. Although inflammation is assumed to be an important cause of anaemia, the association between anaemia and inflammatory markers in patients with HF has not been well established. METHODS: Data from a multicentre randomised clinical trial, in which patients were eligible if they were >18 years of age and admitted for HF (New York Heart Association II-IV), were used. In a subset of 326 patients, haemoglobin (Hb), haematocrit, high sensitivity C-reactive protein (hsCRP), interleukin-(IL) 6, soluble tumour necrosis factor receptor (sTNFR)-1 and erythropoietin (Epo) were measured at discharge and the primary endpoint was all-cause mortality. Follow-up was 18 months. RESULTS:Anaemia (Hb <13 g/dl (men) and <12 g/dl (women)) was present in 40% (130/326) of the study population. Median levels of IL-6, hsCRP and sTNFR-1 were significantly higher in anaemic patients than in non-anaemic patients. Logistic regression demonstrated that each increase in hsCRP values (OR 1.58 per SD log hsCRP; 95% CI 1.09 to 2.29; p=0.016) and each increase in sTNFR-1 values (OR 1.62 per SD log sTNFR-1; 95% CI 1.24 to 2.11; p<0.001) were independently associated with anaemia. Epo (HR 1.31 per log Epo; 95% CI 1.01 to 1.69; p=0.041) and sTNFR-1 (HR 1.47 per log sTNFR-1; 95% CI 1.16 to 1.86; p=0.001) levels were independently associated with outcome. CONCLUSION:Anaemia is present in 40% of patients hospitalised for HF and is independently associated with inflammation.
RCT Entities:
AIMS: Anaemia in heart failure (HF) is associated with a poor prognosis. Although inflammation is assumed to be an important cause of anaemia, the association between anaemia and inflammatory markers in patients with HF has not been well established. METHODS: Data from a multicentre randomised clinical trial, in which patients were eligible if they were >18 years of age and admitted for HF (New York Heart Association II-IV), were used. In a subset of 326 patients, haemoglobin (Hb), haematocrit, high sensitivity C-reactive protein (hsCRP), interleukin-(IL) 6, soluble tumour necrosis factor receptor (sTNFR)-1 and erythropoietin (Epo) were measured at discharge and the primary endpoint was all-cause mortality. Follow-up was 18 months. RESULTS:Anaemia (Hb <13 g/dl (men) and <12 g/dl (women)) was present in 40% (130/326) of the study population. Median levels of IL-6, hsCRP and sTNFR-1 were significantly higher in anaemic patients than in non-anaemic patients. Logistic regression demonstrated that each increase in hsCRP values (OR 1.58 per SD log hsCRP; 95% CI 1.09 to 2.29; p=0.016) and each increase in sTNFR-1 values (OR 1.62 per SD log sTNFR-1; 95% CI 1.24 to 2.11; p<0.001) were independently associated with anaemia. Epo (HR 1.31 per log Epo; 95% CI 1.01 to 1.69; p=0.041) and sTNFR-1 (HR 1.47 per log sTNFR-1; 95% CI 1.16 to 1.86; p=0.001) levels were independently associated with outcome. CONCLUSION:Anaemia is present in 40% of patients hospitalised for HF and is independently associated with inflammation.
Authors: Lennaert Kleijn; B Daan Westenbrink; Vincent M van Deursen; Kevin Damman; Rudolf A de Boer; Hans L Hillege; Dirk J van Veldhuisen; Adriaan A Voors; Peter van der Meer Journal: Clin Res Cardiol Date: 2014-02-08 Impact factor: 5.460
Authors: Vincent M van Deursen; Kevin Damman; Peter van der Meer; Peter J Wijkstra; Gert-Jan Luijckx; Andre van Beek; Dirk J van Veldhuisen; Adriaan A Voors Journal: Heart Fail Rev Date: 2014-03 Impact factor: 4.214
Authors: Victor Nauffal; Yiyi Zhang; Tanyanan Tanawuttiwat; Elena Blasco-Colmenares; John Rickard; Joseph E Marine; Barbara Butcher; Sanaz Norgard; Timm-Michael Dickfeld; Kenneth A Ellenbogen; Eliseo Guallar; Gordon F Tomaselli; Alan Cheng Journal: PLoS One Date: 2017-04-07 Impact factor: 3.240
Authors: Ridha I S Alnuwaysir; Niels Grote Beverborg; Martijn F Hoes; George Markousis-Mavrogenis; Karla A Gomez; Haye H van der Wal; John G F Cleland; Kenneth Dickstein; Chim C Lang; Leong L Ng; Piotr Ponikowski; Stefan D Anker; Dirk J van Veldhuisen; Adriaan A Voors; Peter van der Meer Journal: Eur J Heart Fail Date: 2021-12-09 Impact factor: 17.349