Namki Hong1, Jong-Chan Youn1, Jaewon Oh1, Hye Sun Lee2, Sungha Park1, Donghoon Choi1, Seok-Min Kang3. 1. Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: smkang@yuhs.ac.
Abstract
BACKGROUND AND PURPOSE: In patients with acute decompensated heart failure (ADHF), the prognostic value of new-onset anemia with regard to renal function has not been investigated. METHODS AND SUBJECTS: Consecutive 299 ADHF patients (162 men, 62 ± 14 years) were enrolled. Cardiovascular (CV) events composite of CV mortality and rehospitalization occurred in 113 patients (37.8%) during 2 years of follow-up. RESULTS: Baseline anemia was prevalent (n = 124, 41.5%) and 43 patients (14.4%) had new-onset anemia at 1 month after discharge. Baseline anemia was strongly associated with CV events risk in overall [hazard ratio (HR): 1.79, 95% CI: 1.17-2.74, p = 0.006] and those with preserved renal function [estimated glomerular filtration rate (eGFR)≥ 45 mL/min/1.73 m(2)] (HR: 1.81, 95% CI: 1.05-3.12, p = 0.031). In patients with severe renal dysfunction (eGFR<45 mL/min/1.73 m(2)), new-onset anemia independently predicted CV events (HR: 2.72, 95% CI: 1.09-6.76, p = 0.031) whereas baseline anemia did not (HR: 1.28, 95% CI: 0.61-2.65, p = 0.505). New-onset anemia was significantly associated with hemodilution, which may reflect inadequate decongestion in ADHF patients. CONCLUSIONS: Baseline anemia was an independent prognostic factor in overall ADHF patients and those with preserved renal function. New-onset anemia as a surrogate for hemodilution better predicted CV events than baseline anemia in ADHF patients with severe renal dysfunction.
BACKGROUND AND PURPOSE: In patients with acute decompensated heart failure (ADHF), the prognostic value of new-onset anemia with regard to renal function has not been investigated. METHODS AND SUBJECTS: Consecutive 299 ADHFpatients (162 men, 62 ± 14 years) were enrolled. Cardiovascular (CV) events composite of CV mortality and rehospitalization occurred in 113 patients (37.8%) during 2 years of follow-up. RESULTS: Baseline anemia was prevalent (n = 124, 41.5%) and 43 patients (14.4%) had new-onset anemia at 1 month after discharge. Baseline anemia was strongly associated with CV events risk in overall [hazard ratio (HR): 1.79, 95% CI: 1.17-2.74, p = 0.006] and those with preserved renal function [estimated glomerular filtration rate (eGFR)≥ 45 mL/min/1.73 m(2)] (HR: 1.81, 95% CI: 1.05-3.12, p = 0.031). In patients with severe renal dysfunction (eGFR<45 mL/min/1.73 m(2)), new-onset anemia independently predicted CV events (HR: 2.72, 95% CI: 1.09-6.76, p = 0.031) whereas baseline anemia did not (HR: 1.28, 95% CI: 0.61-2.65, p = 0.505). New-onset anemia was significantly associated with hemodilution, which may reflect inadequate decongestion in ADHFpatients. CONCLUSIONS: Baseline anemia was an independent prognostic factor in overall ADHFpatients and those with preserved renal function. New-onset anemia as a surrogate for hemodilution better predicted CV events than baseline anemia in ADHFpatients with severe renal dysfunction.