Carles Díez-López1, Josep Lupón2, Marta de Antonio1, Elisabet Zamora2, Mar Domingo1, Javier Santesmases1, Maria-Isabel Troya1, Maria Boldó1, Antoni Bayes-Genis3. 1. Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 2. Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. 3. Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: abayesgenis@gmail.com.
Abstract
INTRODUCTION AND OBJECTIVES: The influence of hemoglobin kinetics on outcomes in heart failure has been incompletely established. METHODS: Hemoglobin was determined at the first visit and at 6 months. Anemia was defined according to World Health Organization criteria (hemoglobin < 13g/dL for men and hemoglobin < 12g/dL for women). Patients were classified relative to their hemoglobin values as nonanemic (both measurements normal), transiently anemic (anemic at the first visit but not at 6 months), newly anemic (nonanemic initially but anemic at 6 months), or permanently anemic (anemic in both measurements). RESULTS: A total of 1173 consecutive patients (71.9% men, mean age 66.8±12.2 years) were included in the study. In all, 476 patients (40.6%) were considered nonanemic, 170 (14.5%) had transient anemia, 147 (12.5%) developed new-onset anemia, and 380 (32.4%) were persistently anemic. During a follow-up of 3.7±2.8 years after the 6-month visit, 494 patients died. On comprehensive multivariable analyses, anemia (P < .001) and the type of anemia (P < .001) remained as independent predictors of all-cause mortality. Compared with patients without anemia, patients with persistent anemia (hazard ratio [HR] = 1.62; 95% confidence interval [95%CI], 1.30-2.03; P < .001) and new-onset anemia (HR = 1.39; 95%CI, 1.04-1.87, P = .03) had higher mortality, and even transient anemia showed a similar trend, although without reaching statistical significance (HR = 1.31; 95%CI, 0.97-1.77, P = .075). CONCLUSIONS: Anemia, especially persistent and of new-onset, and to a lesser degree, transient anemia, is deleterious in heart failure.
INTRODUCTION AND OBJECTIVES: The influence of hemoglobin kinetics on outcomes in heart failure has been incompletely established. METHODS: Hemoglobin was determined at the first visit and at 6 months. Anemia was defined according to World Health Organization criteria (hemoglobin < 13g/dL for men and hemoglobin < 12g/dL for women). Patients were classified relative to their hemoglobin values as nonanemic (both measurements normal), transiently anemic (anemic at the first visit but not at 6 months), newly anemic (nonanemic initially but anemic at 6 months), or permanently anemic (anemic in both measurements). RESULTS: A total of 1173 consecutive patients (71.9% men, mean age 66.8±12.2 years) were included in the study. In all, 476 patients (40.6%) were considered nonanemic, 170 (14.5%) had transient anemia, 147 (12.5%) developed new-onset anemia, and 380 (32.4%) were persistently anemic. During a follow-up of 3.7±2.8 years after the 6-month visit, 494 patients died. On comprehensive multivariable analyses, anemia (P < .001) and the type of anemia (P < .001) remained as independent predictors of all-cause mortality. Compared with patients without anemia, patients with persistent anemia (hazard ratio [HR] = 1.62; 95% confidence interval [95%CI], 1.30-2.03; P < .001) and new-onset anemia (HR = 1.39; 95%CI, 1.04-1.87, P = .03) had higher mortality, and even transient anemia showed a similar trend, although without reaching statistical significance (HR = 1.31; 95%CI, 0.97-1.77, P = .075). CONCLUSIONS:Anemia, especially persistent and of new-onset, and to a lesser degree, transient anemia, is deleterious in heart failure.
Authors: Wallace Chow; Christopher Wong; Jerrett K Lau; Vincent Chow; Leonard Kritharides; Austin C C Ng Journal: BMJ Open Date: 2019-05-01 Impact factor: 2.692
Authors: Paloma Gastelurrutia; Josep Lupón; Pedro Moliner; Xiaobo Yang; German Cediel; Marta de Antonio; Mar Domingo; Salvador Altimir; Beatriz González; Margarita Rodríguez; Carmen Rivas; Violeta Díaz; Erik Fung; Elisabet Zamora; Javier Santesmases; Julio Núñez; Jean Woo; Antoni Bayes-Genis Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2018-04-19
Authors: Mar Domingo; Josep Lupón; Nicolas Girerd; Laura Conangla; Marta de Antonio; Pedro Moliner; Evelyn Santiago-Vacas; Pau Codina; German Cediel; Giosafat Spitaleri; Beatriz González; Violeta Diaz; Carmen Rivas; Patricia Velayos; Julio Núñez; Antoni Bayes-Genís Journal: ESC Heart Fail Date: 2021-11-01