Katsuya Kajimoto1, Yuichiro Minami2, Shigeru Otsubo3, Naoki Sato4. 1. Division of Cardiology, Sekikawa Hospital, Japan. 2. Department of Cardiology, Tokyo Women's Medical University, Japan. 3. Department of Blood Purification, Tohto Sangenjaya Clinic, Japan. 4. Department of Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Japan.
Abstract
BACKGROUND: In acute decompensated heart failure patients with a preserved or reduced ejection fraction, the association of admission and discharge anemia status with outcomes remains unclear. METHODS AND RESULTS: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4433 patients (2017 with a preserved and 2416 with a reduced ejection fraction) were examined to investigate associations among the anemia status at admission and discharge (no anemia, developed anemia, resolved anemia, or persistent anemia), a preserved or reduced ejection fraction and the primary endpoint (all-cause death and readmission for heart failure). In the preserved ejection fraction group, adjusted analysis showed that either developed or persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.53; 95% confidence interval (CI): 1.11-2.11; p=0.009 and hazard ratio: 1.60; 95% CI: 1.26-2.04; p<0.001, respectively), but there was no association between resolved anemia and the primary endpoint (hazard ratio: 0.98; 95% CI: 0.67-1.45; p=0.937). In the reduced ejection fraction group, either developed or resolved anemia was associated with a tendency toward higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.29; 95% CI: 0.95-1.62; p=0.089, and hazard ratio: 1.31; 95% CI: 0.96-1.77; p=0.085, respectively), while persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.36; 95% CI: 1.12-1.65; p=0.002). CONCLUSIONS: In acute decompensated heart failure patients, the association of admission and discharge anemia status with outcomes differs markedly between patients with a preserved or reduced ejection fraction.
BACKGROUND: In acute decompensated heart failure patients with a preserved or reduced ejection fraction, the association of admission and discharge anemia status with outcomes remains unclear. METHODS AND RESULTS: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4433 patients (2017 with a preserved and 2416 with a reduced ejection fraction) were examined to investigate associations among the anemia status at admission and discharge (no anemia, developed anemia, resolved anemia, or persistent anemia), a preserved or reduced ejection fraction and the primary endpoint (all-cause death and readmission for heart failure). In the preserved ejection fraction group, adjusted analysis showed that either developed or persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.53; 95% confidence interval (CI): 1.11-2.11; p=0.009 and hazard ratio: 1.60; 95% CI: 1.26-2.04; p<0.001, respectively), but there was no association between resolved anemia and the primary endpoint (hazard ratio: 0.98; 95% CI: 0.67-1.45; p=0.937). In the reduced ejection fraction group, either developed or resolved anemia was associated with a tendency toward higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.29; 95% CI: 0.95-1.62; p=0.089, and hazard ratio: 1.31; 95% CI: 0.96-1.77; p=0.085, respectively), while persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.36; 95% CI: 1.12-1.65; p=0.002). CONCLUSIONS: In acute decompensated heart failure patients, the association of admission and discharge anemia status with outcomes differs markedly between patients with a preserved or reduced ejection fraction.
Entities:
Keywords:
Heart failure; anemia; left ventricular ejection fraction; outcomes assessment
Authors: Nareg H Roubinian; Edward L Murphy; Dustin G Mark; Darrell J Triulzi; Jeffrey L Carson; Catherine Lee; Patricia Kipnis; Steven Kleinman; Vincent X Liu; Gabriel J Escobar Journal: Ann Intern Med Date: 2018-12-18 Impact factor: 25.391
Authors: Lorraine Sazgary; Christian Puelacher; Giovanna Lurati Buse; Noemi Glarner; Andreas Lampart; Daniel Bolliger; Luzius Steiner; Lorenz Gürke; Thomas Wolff; Edin Mujagic; Stefan Schaeren; Didier Lardinois; Jacqueline Espinola; Christoph Kindler; Angelika Hammerer-Lercher; Ivo Strebel; Karin Wildi; Reka Hidvegi; Johanna Gueckel; Christina Hollenstein; Tobias Breidthardt; Katharina Rentsch; Andreas Buser; Danielle M Gualandro; Christian Mueller Journal: Eur Heart J Acute Cardiovasc Care Date: 2020-10-14